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Alabama

High School

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SUPPLEMENTARYSCHEDULES

No.1-BankingRelations(alistofallmybankaccounts,includingsavingsandloans.)

Nameand

LocationofBank

Account# Cash

Balance

OutstandingLoans MaturityDate HowGuaranteed

No.2-AccountsReceivable(alistofthelargestamountsowedtome.)

Name&Address

ofDebtor

AmountOwing AgeofDebt NatureofDebt&SecurityHeld DateofPayment

No.3-LifeInsurance

NameofPerson

Insured

Policy# Nameof

Beneficiary

Insurance

Company

Face

Amountof

Policy

Total

Cash

Surrender

Value

Total

Loan

Against

Policy

IsPolicy

Assigned

Type

of

Policy

Amountof

YearlyPremium

No.4-Stocks,Bonds,andMutualFunds

FaceValue

(Bonds)

No.ofShares

(Stocks)

Description

ofSecurity

DueDate RegistrationinNameofand

#

Cost Present

Market

Value

Income

Received

LastYear

ToWhomPledged

Brokers Name(s) Indicate on each if stocks or bonds are held by the broker (B) or by yourself (S) Balance of Margin Account(s)

_________________________________________________________ __________________

_________________________________________________________ __________________

_________________________________________________________ __________________

No.5-RealEstate(legalandequitabletitletoallrealestatelistedinthisstatementissolelyinthenameoftheundersigned,exceptasfollows)

Typeof

Property

(home,

Business,

land,etc.

Address Mortgages

orLiens

Mortgageor

LienHeldby

DueDates

and

Amountsof

Payments

Assessed

Value

Present

Market

Value

To

Whom

Pledged

UnpaidTaxes

Year Amount

No.6-CreditorsIbuygoodsprincipallyfrom:

NameofCreditor Address

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ASSETS $ LIABILITIES $

Cashonhand,andunrestrictedinbanks

(seeScheduleNo.1)

NotesPayabletobanks,unsecureddirectborrowings

only(seeScheduleNo.1)

U.S.GovernmentSecurities

NotesPayabletobanks,secureddirectborrowings

only(seeScheduleNo.1)

AccountsandLoansReceivable

(seeScheduleNo.2) NotesPayabletoOthers,unsecured

NotesReceivable,notdiscounted

(seeScheduleNo.2) NotesPayabletoothers,secured

LifeInsurance,cashsurrendervalue

(donotdeductloans)(seeScheduleNo.3)

LoansagainstLifeInsurance

(seeScheduleNo.3)

StocksandBonds(seeScheduleNo.4) AccountsPayable

RealEstate(seeScheduleNo.5) InterestPayable

Automobiles(registeredinownname) TaxesandAssessmentsPayable(seeScheduleNo.5)

Year: Make: Model:

Mortgagespayableonrealestate(seeScheduleNo.5)

Year: Make: Model: BrokersMarginAccounts

(seeScheduleNo.4)

OtherAssets(itemize) OtherLiabilities(itemize)

TOTALASSETS $ TOTALLIABILITIES $

NETWORTH

(TotalAssetsminusTotalLiabilities) $

ANNUALINCOME LastYear PreviousYear CONTINGENTLIABILITIES

Salary $ $ AsEndorserofCo-maker $

BonusandCommissions Onleasesorcontracts

Dividends LegalClaims

RealEstate ProvisionforFederalIncomeTaxes

Other(Itemize) Otherspecialdebt

TOTAL

(AdjustedGrossIncome)$ $ TOTAL $

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Additional Applicants (optional)

Additional Applicant 1

Additional Applicant 2

Alabama

Alabama

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Additional Applicants (cont.)

Additional Applicant 3

Additional Applicant 4

Alabama

Alabama

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