Simple Income Statement For Small Business
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Farmington Bank • One Farm Glen Boulevard • Farmington, CT 06032 • farmingtonbankct.com Page 1 Member FDIC Equal Housing Lender SCHEDULE A – MARKETABLE SECURITIES, NON-MARKETABLE SECURITIES BONDS Number of Shares/ Bond Face Value Marketable or Non-Marketable Are these Pledged Description Source of Value Market Value SCHEDULE B – REAL ESTATE Address Residential or Commercial Percent Ownership Purchase Date Purchase Price Estimated Market Value Mortgage or Lien Balance Face Amount Cash Surrender Value Total Monthly Payment SCHEDULE C – LIFE INSURANCE CARRIED Name of Insurance Company Owner of Policy Beneficiary Loan Balance SCHEDULE D – NOTES PAYABLE CREDIT CARD / REVOLVING LOANS Name Address of Lender Name of Borrower Original Date Original Balance Current Balance Monthly Payment Secured or Unsecured REPRESENTATIONS AND AUTHORIZATION AGREEMENT Each of the undersigned certifies that all pages hereof and the information inserted herein has been carefully read and is true, correct, and complete..
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