Pa2 Collection Information Statement For Businesses Page 2
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4General Financial Information (continued)
Real Property
Brief Description and Type of Ownership
Physical Address
Life Insurance policies owned with business as beneficiary
Name Insured
Company
Policy Number
Type
Face Amount
Available Loan Value
Total
Additional information regarding financial condition (Court proceedings, bankruptcies filed or anticipated, transfers of assets for less than full value, changes in market value,
etc.; include information regarding company participation in trusts, estates, profit sharing plans, etc.)
Accounts / Notes receivable (Include current contract jobs, loans to stockholders, officers, partner, etc.)
Name
Address
Amount Due
Date Due
Status
Total
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