Form Boe-490-C - Offer In Compromise Application Page 10

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Corporate Application
BOE-490-C REV. 1 (11-08)
SeCtION 6. ASSet ANd LIABILItY ANALYSIS (Continued)
Other assets
Value
9. Notes/accounts receivable (from Section 5)
10. Judgments/settlements receivable (from Section 5)
11. Machinery and equipment (from Section 5)
12. Merchandise inventory (from Section 5)
13. Aircraft, watercraft (please list CF number or Hull ID number)
14. Interest in partnerships
15. Interest in trusts
16. Other assets (include description)
17. Other assets
tOtAL OtHer ASSetS >>
18.
Subtotal of assets (current, equity, and other) >>
Current liabilities (attach additional pages as needed)
19. Lines of credit (amount owed from Section 5)
20. Notes/accounts payable (include description)
21. Taxes owed to IRS (provide a copy of recent notices)
22. Taxes owed to FTB (provide a copy of recent notices)
23. Taxes owed to EDD (provide a copy of recent notices)
24. Judgments (provide a copy)
25. Other liabilities (include description)
tOtAL LIABILItIeS >>
SeCtION 7. mONtHLY INCOme ANd eXPeNSe ANALYSIS
Income (Please furnish the information requested below from income tax returns, as adjusted, for the past three years.)
YEAR
YEAR
YEAR
26. Gross receipts from sales, services, etc.
27. Gross rental income
28. Interest
29. Dividends
30. Royalties
31. Other income (include description)
OFFER IN COMPROMISE APPLICATION
11

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