Page 1
Due to printing requirements, the Name and Address on the Main Info sheet have been shortened on this form. Select the check box at the top of the form to make changes, or press F3 on the entries if no changes are necessary.
Line 6 – Press F9 on the Name column for an additional statement.
Fill in the applicable lines.
Page 2
Fill in the applicable lines.
Line 8 – Press F9 on the Year column for an additional statement.
Line 9 – Press F9 on the Year column for an additional statement.
Page 3
Fill in the applicable lines.
Line 10 – Press F9 on the Street Address column for an additional statement.
Line 11 – Press F9 on the Description column under Machinery, Equipment or Other for an additional statement.
Line 12 – Press F9 on the Name column for an additional statement.
In the Current Value column, indicate the amount you could sell the asset for today.
Page 4
Fill in the applicable lines.
Line 13 – Press F9 on the Name column, under Checking Accounts or Savings Accounts, for an additional statement.
Line 14 – Press F9 on the Type column for an additional statement.
Line 16 – Press F9 on the Name of Credit Institution column for an additional statement.
Page 5
Fill in all applicable lines.
Page 6
Fill in the applicable lines.
Press F9 in the Name column for an additional statement.
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