Professional Documents
Culture Documents
SALN2015 Addl Sheets
SALN2015 Addl Sheets
NAME:
POSITION:
(Family Name)
(First Name)
(M.I.)
AGENCY/OFFICE:
Real Properties
DESCRIPTION
KIND
(e.g. residential,
commercial, industrial,
agricultural and mixed
use)
LOCATION
ASSESSED
CURRENT FAIR
VALUE
MARKET VALUE
ACQUISITION
YEAR
ACQUISITION COST
MODE
b. Personal Properties
DESCRIPTION
YEAR ACQUIRED
ACQUISITION COST/AMOUNT
2 . LIABILITIES
NATURE
NAME OF CREDITORS
OUTSTANDING BALANCE
NAME OF ENTITY/BUSINESS
ENTERPRISE
BUSINESS ADDRESS
NATURE OF BUSINESS
INTEREST &/OR FINANCIAL
CONNECTION
Page __ of ___
DATE OF ACQUISITION OF
INTEREST OR CONNECTION
NAME:
POSITION:
(Family Name)
(First Name)
(M.I.)
AGENCY/OFFICE:
Real Properties
DESCRIPTION
KIND
(e.g. residential,
commercial, industrial,
agricultural and mixed
use)
LOCATION
ASSESSED
CURRENT FAIR
VALUE
MARKET VALUE
ACQUISITION
YEAR
ACQUISITION COST
MODE
Subtotal:
b. Personal Properties
DESCRIPTION
YEAR ACQUIRED
ACQUISITION COST/AMOUNT
Subtotal :
TOTAL ASSETS (a+b):
2 . LIABILITIES
NATURE
NAME OF CREDITORS
TOTAL LIABILITIES:
Page __ of ___
OUTSTANDING BALANCE
NAME OF ENTITY/BUSINESS
ENTERPRISE
BUSINESS ADDRESS
NATURE OF BUSINESS
INTEREST &/OR FINANCIAL
CONNECTION
Page __ of ___
DATE OF ACQUISITION OF
INTEREST OR CONNECTION