(Use attachments if necessary. Each attachment must be identified as part of this statement and signed.)
Section 2. Notes Payable to Banks and Others.
Names and Addresses of
Original
Current
Payment
Frequency
How Secured or Endorsed
Noteholder(s)
Balance
Balance
Amount
(monthly, etc.)
Type of Collateral
(Use attachments if necessary. Each attachment must be identified as part of this statement and signed.)
Section 3. Stocks and Bonds.
Market Value
Date of
Number of Shares
Name of Securities
Cost
Total Value
Quotation/Exchange
Quotation/Exchange
(List each parcel separately. Use attachment if necessary. Each attachment must be identified as a part of this statement
Section 4. Real Estate Owned.
and signed.)
Property A
Property B
Property C
Type of Real Estate (e.g.
Primary Residence, Other
Residence, Rental Property,
Land, etc.)
Address
Date Purchased
Original Cost
Present Market Value
Name & Address of
Mortgage Holder
Mortgage Account Number
Mortgage Balance
Amount of Payment per
Month/Year
Status of Mortgage
Section 5. Other Personal Property and Other Assets. (Describe, and, if any is pledged as security, state name and address of lien
holder, amount of lien, terms of payment and, if delinquent, describe delinquency.)
Section 6. Unpaid Taxes. (Describe in detail as to type, to whom payable, when due, amount, and to what property, if any, a tax
lien attaches.)
Section 7. Other Liabilities. (Describe in detail.)
SBA Form 413 (7a/504/SBG) (09-14) Previous Editions Obsolete
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