Financial Statement Page 3
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7D. CASH, BANK ACCOUNTS, PENSIONS, AND RETIREMENT ACCOUNTS. List cash, all savings and checking accounts,
money market accounts, certificates of deposit, profit sharing plans, pension plans, IRAs, Keoughs, annuities, etc. Give current
market value of each item. If you need more space, check here ❐ and add attachments as necessary.
Name of Institution
Description of Account
Date Acquired
Account Number
Current Value
Non-
marital
1.
E. STOCKS, BONDS, AND OTHER SECURITIES. List all stocks, bonds, warrants, options, debentures, notes, or any other
securities. Give your best estimate of the current market value of each item. Do not deduct debts secured by any item. If there is a
debt, check in the debt column and list the debt in Section I, Debts, on page 4. If you need more space, check here ❐ and add
attachments as necessary.
Name
Description and Number of Units
Date Acquired
Current Value
Debt
Non-
marital
1.
F. LIFE AND DISABILITY INSURANCE. Give complete information. Do not deduct debts secured by any item. If there is a
debt, check in the debt column and list the debt in Section I, Debts, on page 4.If you need more space, check here ❐ and add
attachments as necessary.
Company and
Type of Policy
Beneficiary
Death
Current Cash
Debt
Non-
Policy Number
Benefit
Surrender Value
marital
1.
G. BUSINESS INTERESTS. Show any interest in a business. Business includes sole proprietorships, partnerships, professional
associates, accounts receivable, inventory, and assets. Give your best estimate of the current market value of the business/assets. If
there are debts, check in the debt column, and list the debts in Section I, Debts, on page 4.If you need more space, check here ❐ and
add attachments as necessary.
Name of Firm or Company
Extent and Type of Interest
Date Acquired
Current Value
Debt
Non-
marital
1.
Pursuant to M.R.Civ.P. 108(d)(3), the information on this form is not subject to public inspection.
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