Asset And Debt Statement Page 2

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Page 2
5.
VEHICLES: (Autos, Trucks, Motorcycles, Trailers, Campers, Boats, etc.)
Year
Make
Title (H, W, J)
Current Market Value
Debt Owed Against
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6.
REAL PROPERTY:
Date of
Current
Total
Address
Fee or Lease
Title (H, W, J)
Acquisition Cost
Gross Value
Debt Owed
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
7.
LIFE INSURANCE:
Title
Debt Owed
Company
Person Insured
Face Amount
Beneficiary
(H, W, J)
Cash Value
Against
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
8.
RETIREMENT; PENSION; PROFIT SHARING ACCOUNTS:
Total
Employer or Company
Title (H, W, J)
Type of Plan
Years in Plan
Value
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
9.
ALL OTHER MAJOR ASSETS: (Furniture, Household Effects, Art, Stamps, Coins, Tools,
Equipment, Jewelry, Accounts Receivable, Investment Assets, Business Assets, Cemetery Plots or
Niches, Tax Refunds Due, etc.)
General Description
Title (H, W, J)
Estimated Gross Value
Debt Owed Against
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

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