Business Financial Statement Form 2 - Free Download | Page 2
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SUPPLEMENTARY SCHEDULES
(NOTE: If space is insufficient, attach separate sheet with additional information)
SCHEDULE 1 - CASH
Name, Branch & Location of Bank Amount
SCHEDULE 2 - STOCKS AND BONDS
Name of Security No. of Shares Price Per Share Total Market
Value
Listed Securities
Unlisted Securities
SCHEDULE 3 - NOTES RECEIVABLE
Name & Address of Debtor Amount Due Date Security Pledged
To Whom
SCHEDULE 4 - REAL ESTATE
Location/Description Year
Acq'd
Cost
Market
Value
Monthly
Income
Monthly
Payment
Mortgage
Balance
Mortgage or
Lien Holder
SCHEDULE 5 - BUSINESS VEHICLES AND EQUIPMENT
Description and Capacity Year
Mfg'd
Year
Acq'd
Cost Book Value Monthly
Payment
Loan
Balance
SCHEDULE 6 - NOTES PAYABLE
Payable to Whom Due
Date
Interest
Rate
Monthly
Payment
Amount Security
I hereby certify and declare that the above statement presents accurately my financial condition to the best of my knowledge and belief and I hereby
authorize and request any person, firm or corporation to furnish any information requested by the Surety concerning any transaction with the
undersigned; and the said Surety is authorized to obtain information to confirm this financial statement and may furnish copies of the foregoing statement
and any information which it now has or may hereafter obtain to other companies for the purpose of securing reinsurance or co-suretyship.
Signature Date
South Coast Surety 800-361-1720 Fax 949-361-9926 www.southcoastsurety.com
