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7/27/2019 RaceWay Single Applicantdfdfd
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Alabama
High School
7/27/2019 RaceWay Single Applicantdfdfd
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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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