Statement of Assets

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17/17 EXAMPLES

Text in this Example:

BANK ACCOUNTS
LIFE INSURANCE
Name of Bank or Financial Institution:
Type of Policy:
Account Number:
Policy Number:
Type of Account:
Insurance Agent:
Name of Owner:
Location of Insurance Policy:
Title of Property
Approximate Market Value
Approximate Current Value
Description:
AUTOMOBILES
REAL ESTATE
Make, Model, Year:
Location of Real Estate:
Loan Amount:
How is it Owned?:
Load Holder and Holder's Address:
Date Purchased:
Location of Title:
Tax Assessment Value:
STOCK AND BONDS
TITLED ASSETS
Investment Broker:
Location of Asset:
Type of Asset:
Account, Certificate, or Serial Number:
Location of Title of Asset:
Maturity Date:
Purchase Price of Asset:
PROFESSIONAL/BUSINESS
OTHER
Type of Business:
Type and Amount of Ownership:
Business Contacts:
Share of Ownership Business:
Full Legal Name:
Address:
Telephone Number:
State of Domicile:
Home of Record:
Date of Birth:
Place of Birth:
Social Security Number:
STATEMENT OF ASSETS