ADDRESS: _____________________________________________________________________
CITY:
PHONE: __________________________E-MAIL: _______________________________________
Section
I
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ASSETS: |
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LIABILITIES: |
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Cash in Bank: |
$______________ |
Mortgages |
$______________ |
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Stocks & Bonds: |
$______________ |
Credit Cards Balance: |
$______________ |
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Automobiles: |
$______________ |
Auto Loans: |
$______________ |
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Real
Estate |
$______________ |
Installment Loans: |
$______________ |
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Retirement Acct: |
$______________ |
2nd Mtg./Line of Cr. |
$______________ |
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Personal Property: |
$______________ |
Other Debts: |
$______________ |
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Other Assets: |
$______________ |
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Total Assets: |
$______________ |
Total Liabilities: |
$_____________ |
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Section II
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Real Estate |
Current Value |
Date Purchased |
Mortgage |
Balance |
Monthly Pmt. |
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Property 1 |
$ _________ |
_________ |
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$ _________ |
$ _________ |
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Property 2 |
$ _________ |
_________ |
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$ _________ |
$ _________ |
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Property 3 |
$ _________ |
_________ |
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$ _________ |
$ _________ |
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Total: |
$ _________ |
_________ |
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$ _________ |
$ _________ |
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_____ Bankruptcy |
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_____ Charge-offs |
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_____ Slow Pays |
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_____ Judgments |
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____ Tax Liens |
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____ Law suits against you |
A minimum of 30% cash injection is
required.
How much Liquid Capital (cash) do you have to put towards the
purchase of this business? $________________.
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__________________________________________________ |
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___________________ |
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Signature |
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Date |
PRINT OUT THIS FORM FIRST, THEN FAX COMPLETED INFORMATION TO (619) 232-8813