Financial Statement Page 7
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12PROPERTY OWNED BY YOU -
CONTINUED
CURRENT VALUE OF YOUR SHARE
$
NAME AND TYPE OF INVESTMENT
FULL NAMES OF ALL OWNERS
NUMBER OF SHARES HELD
YOUR % SHARE
39
Life Insurance
$
POLICY TYPE
POLICY NO.
policies
NAME OF INSURANCE COMPANY
FULL NAMES OF ALL OWNERS
YOUR % SHARE
40
Motor vehicle
$
YEAR
MAKE
MODEL
REGISTRATION NO.
FULL NAME OF REGISTERED OWNER/S
YOUR % SHARE
$
YEAR
MAKE
MODEL
REGISTRATION NO.
FULL NAME OF REGISTERED OWNER/S
YOUR % SHARE
41
Interest in a
$
NAME OF BUSINESS
business
including a
business
ADDRESS OF BUSINESS
operated by
you as a sole
trader, in a
YOUR % SHARE
partnership or
through a
Business type (Mark [X] which applies)
proprietary
company or a
Sole trader
Partnership
Proprietary company / trust
trust
42
Household
$
contents
43
Other personal
$
SPECIFY
property
YOUR % SHARE
TOTAL VALUE OF PROPERTY OWNED BY YOU
$
44
WRITE THIS ITEM 44 TOTAL AT ITEM 2C ON PAGE 2 OF THIS FORM
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