Form A010 - Financial Disclosure Report Nomination Filing Page 12
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13FINANCIAL STATEMENT
NET WORTH
Provide a complete, current financial net worth statement which itemizes in detail all assets (including bank
accounts, real estate, securities, trusts, investments, and other financial holdings) all liabilities (including debts,
mortgages, loans, and other financial obligations) of yourself, your spouse, and other immediate members of your
household.
LIABILITIES
ASSETS
476
943
Cash on hand and in banks
Notes payable to banks-secured (auto)
U.S. Government securities
Notes payable to banks-unsecured
4
821
463
Listed securities -see schedule
Notes payable to relatives
Unlisted securities
Notes payable to others
Accounts and notes receivable:
Accounts and bills due
Due from relatives and friends
Unpaid income tax
Due from others
Other unpaid income and interest
Real estate mortgages payable-personal
Doubtful
residence
326
352
1
245
333
Real estate owned-see schedule
Chattel mortgages and other liens payable
Real estate mortgages receivable
Other debts-itemize:
31
800
Autos and other personal property
Cash value-life insurance
Other assets itemize:
65
680
Munger, Tolles & Olson capital account
326
352
Total liabilities
6
314
867
Net Worth
641
6
641
219
6
219
Total liabilities and net worth
Total Assets
CONTINGENT LIABILITIES
GENERAL INFORMATION
No
Are any assets pledged? (Add schedule)
As endorser, comaker or guarantor
Are you defendant in any suits or legal
On leases or contracts
No
actions?
No
Have you ever taken bankruptcy?
Legal Claims
Provision for Federal Income Tax
Other special debt
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