Preview Financial Capability Statement

CASH

LOANS AND PAYABLES

REPUBLICOFTHEPHILIPPINES

DepartmentofTransportationandCommunications

LANDTRANSPORTATIONFRANCHISINGANDREGULATORYBOARD

EastAvenue,QuezonCity

STATEMENTOFFINANCIALCAPABILITY

(ACTUALWORKINGCAPITAL)

ForIndividualOperator(Pleaseaccomplishbelow)

LASTNAME

FIRSTNAME

MIDDLENAME

DATEOFBIRTH SEX M F TINNO.

ForCorporation/Cooperative/Others(Pleaseaccomplishbelow)

NAMEOFCORPORATION/COOPERATIVE/OTHERS

SEC/CDA REGISTRATION NO. TINNO.

NAMEOFAUTHORIZEDREPRESENTATIVE

I.CURRENTASSETS AMOUNT/VALUE

CASH

CashonHand

CashatBank(Savings/Current)

Others

PROPERTIES(CurrentorMarketValue)

RealEstate

Vehicles

Others

INVESTMENTS

CertificatesofDeposit(TimeDeposit,etc.)

Securities(Stocks,Bonds,MutualFunds,etc.)

BusinessInvestments(worthofshares,etc.)

InsurancePolicies(CashSurrenderValue)

Others

TOTALASSETS

II.CURRENTLIABILITIES AMOUNT/VALUE

LOANS AND PAYABLES

 

CreditCardDebts

Loan/s(Housing,auto,etc)

Others

INVESTMENTDEBTS

Business/InsuranceDebts

Others

TOTALLIABILITIES

TOTALWORKINGCAPITAL(TotalAssets‐TotalLiabilities)

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