Form Cm-2 - Hawaii Statement Of Financial Condition And Other Information
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4Department of Taxation - State of Hawaii
Hawaii
STATEMENT OF FINANCIAL CONDITION AND OTHER INFORMATION
Form CM - 2
(Rev. Oct 95)
Section I.
General Information - For Individuals
1. Taxpayer(s) name(s) and address
2. Home phone no.
3. Marital status
4a. Taxpayer's social security no.
b. Spouse's social security no.
5a. Taxpayer's date of birth
b. Spouse's date of birth
6. Other names or aliases
7. Name, age, social security number, and relationship of dependents living in your household.
Section II.
Employment Information
8. Taxpayer's employer or business
a. How long employed?
b. Business phone no.
c. Occupation
(name and address)
d. Check appropriate item
( ) Wage earner
( ) Sole proprietor
( ) Partner
9. Spouse's employer or business
a. How long employed?
c. Business phone no.
c. Occupation
(name and address)
d. Check appropriate item
( ) Wage earner
( ) Sole proprietor
( ) Partner
Section III.
General Financial Information
10. Bank accounts (include Savings & Loans, Credit Unions, IRA and Retirment Plans, Certificate of Deposits, etc.) Attach additional
sheets as necessary.
Name of Institution
Address
Type of Account
Account No.
Balance
Total (Enter in Item 17)
Form CM-2 Page 1
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