Form D-2 - Financial Review Of Debtor'S Non-Farming/non-Fishing Business
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1UNITED STATES BANKRUPTCY COURT
DISTRICT OF OREGON
In re
) Case No. ________________
)
)
EX. D-2
) FINANCIAL REVIEW OF DEBTOR'S
) NON-FARMING/NON-FISHING BUSINESS
) [File With Statement of Financial Affairs in
)
Chapter 12/13 Cases If Debtor Earns Any
) Income From Operation of a NON-FARMING/NON-FISHING
) Sole Proprietorship Business or Debtor or an Insider Owns 20%
Debtor(s)
) or More of a NON-FARMING/NON-FISHING Corporation]
(NOTE:
information directly related to the NON-farming/NON-fishing business operation. This information
ONLY INCLUDE
is to be from the corporate books where necessary.
If an item of Income or Expense does not apply indicate with "N/A.")
ATTACH COPY OF SCHEDULE C FROM PRIOR YEAR'S TAX RETURN (OR EXPLAIN ABSENCE).
Cash Basis
Accrual Basis
INDICATE ACCOUNTING METHOD USED:
BUSINESS NAME, ADDRESS AND PHONE NUMBER: _____________________________________________________________
_____________________________________________________________________________________________________________
NATURE AND STARTING DATE OF BUSINESS AND PERCENTAGE OF OWNERSHIP: ________________________________
_____________________________________________________________________________________________________________
PROJECTED ANNUAL BUSINESS INCOME:
1. Gross Sales or Receipts
$_________________
2. Returns and Allowances
(_________________)
3. Less Cost of Goods Sold
(_________________)
4. Other Income
_________________
5. Gross Income
$_________________
PROJECTED ANNUAL BUSINESS EXPENSES (DO NOT Include Payments Paid Through Plan):
6. Advertising
_________________
7. Car and Truck Expenses
_________________
8. Commissions and Fees
_________________
9. Secured Debt Including Interest (attach list)
_________________
10. Employee Benefits (other than on line 14)
_________________
11. Insurance (other than health)
_________________
12. Legal and Professional Services
_________________
13. Office Expenses
_________________
14. Pension/Profit-Sharing Plans
_________________
15. Rent or Leases
_________________
a. Vehicles, Machinery, Equipment (attach list)
_________________
b. Other Business Property (attach list)
_________________
16. Repairs and Maintenance
_________________
17. Supplies (if not included in line 3)
_________________
18. Taxes and Licenses
a. Payroll Taxes
_________________
b. Income/Self-Employment Tax
_________________
c. Other Taxes/Licenses
_________________
19. Travel
_________________
20. Meals and Entertainment
_________________
21. Utilities
_________________
22. Wages
_________________
23. Other expenses (list separately): __________________________
_________________
_____________________________________________________
_________________
_____________________________________________________
_________________
24. Total Expenses
$_________________
(line 5 less line 24)
$_________________
PROJECTED ANNUAL NET INCOME
$_________________
ESTIMATED AVERAGE NET MONTHLY INCOME
(Attach explanation if not same as amount listed on Schedule I for the question "Regular income from operation of business ...")
Exhibit D-2 (10/17/05)
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