EFTA02683503.pdf

Bank of America Confidential Personal Financial Statement/Certification as of The assets, liabilities, income and expenses described on this (or the attached) financial statement are (check the appropriate box): El Individual If this is an individual financial statement, list all your income, expenses and assets Including your partial ownership interest in and income from any partially owned assets and list all of your direct and contingent liabilities. Joint If this is a joint financial statement, list all of both of your income, expenses and assets Including your partial ownership in and income from any partially owned assets and list all of both of your direct and contingent liabilities. A separate Bank of America Personal Financial Statement may be provided for each individual if you prefer. Yes Yes SIM Wes Position SineMen Phoro I (we) understand that the following questions are addressed to me (us) and I (we) have answered them as appropriate. Yes No 1. Are you named as beneficiary of a trust, will or estate? ___ Yes No 2. Me any of the assets listed herein held under a trust agreement of any type, held in an estate, or in any other name or capacity? Please detail in "Additional Remarks' below. ___ Yes No 3. Are any of the assets listed herein on deposit, located, or otherwise held outside the United States of America? - Yes No 4. Do any of your assets secure any debts that have not been reported in the following schedules? Yes No 5. Me any of the assets listed herein located in the community property states of Arizona, California, Idaho, Louisiana, Nevada. New Mexico, Texas, or Washington? Yes No 6. Are any of your real estate properties used by you in your business? Yes No 7. Have you ever filed for personal bankruptcy, had property you owned foreclosed, or made a settlement or an assignment for the benefit of creditors? Yes No 8. Has any corporation or partnership in which you are (were) a major owner or a general partner ever filed for bankruptcy, had property it owned foreclosed, or made a settlement or assignment for the benefit of creditors? Yes No 9. Are you, or any corporation or partnerships in which you are a major owner or a general partner, a party to any suit or legal action, or are there any unsatisfied judgments against you? Yes No 10. Personal income tax returns have been filed through (year) . Are any income tax returns, whether personal or those of any corporation or partnership in which you are a major owner or a general partner, currently being audited or contested? Yes No 11. Are you an officer, director, or principal shareholder of a financial institution? I (we) have explained fully under "Additional Remarks" on this page (or an attachment) my (our) "Yes" answers to the foregoing questions. Yes No 12. I (we) have made a will; the executor(s) is Additional Remarks The undersigned (I:We) herewith submit to Bank of America (you) this (or the attached) financial and supporting schedules which constitute my (our) personal financial statement. This statement is submitted to you for the purpose of inducing you to extend or maintain credit to me (us) whether as direct obligor(s) or indirectly as guarantor(s) or other indirect obligor(s) of credit extended to others. I (we) hereby certify that this statement presents a true, complete, and correct statement of my (our) financial condition as of the date shown and does not omit any pertinent information. I (we) understand that misrepresenting information on this (or the attached) statement Is a criminal offense under federal law. I (we) will notify you promptly in writing of any material unfavorable change in my (our) financial condition. In the absence of such notice, you may consider this a continuing statement and substantially correct. If I (we) apply for further credit, this statement shall have the same force and effect as if delivered as an original statement of my (our) financial condition at the time I (we) request such further credit. You are hereby authorized to contact credit reporting agencies and other sources for the purpose of verifying any information stated herein or at any time are authorized to answer any questions about your credit experience with me (us), and furnish to Bank of America or any of its subsidiaries information which I (we) have provided to you and information regarding any of my (our) accounts. Signature Date Signature Date EFTA_R1_02000833 EFTA02683503  As oF q/k//3 ('oeds) Pa •e 2 Assets (omit cents Liabilities (omit cents) In this Bank ortgages Primary Residence Cc-SA In Other Institutions • ayable Oth Wholly-Owned RE (Schedule 1) Marketable Schedule 7) Partially Owned RE Securities Not Publicly Traded Notes To this Bank (Schedule 2) Payable Other Notes Payable Accounts Receivable/Notes Receivable (Sch. 3) Net Cash Value Ins. & Annuities (Schedule 4) (Schedule 6 & 8) Margin Account Real Primary Residence Taxes Income Taxes Estate Other Wholly-Owned • Owing Other Taxes (Schedule 7) Partially Owned RE Unrealized Asset Apprec. Other Partnership Interest Estimated Credit Card Balance Equipment & Other Business Assets (Sch. 8) Accounts Payable Deferred Comp & Retirement Plans (Sch. 5) Other Liabilities (Itemize on page 1 or attachment) Other Assets (Itemize on pg. 1or attach) if- Offshore Assets (Itemize on pg. 1 or attach) I Total Liabilities I Net Worth (Assets Less Liabilities) I Contingent a•II es Instructions: State Total Amount by Type of Liability and Provide Appropriate DetailIn The Space Below. endorsed, guaranteed or otherwise agreed to Contingent liabilities are financial obligations of other individuals, partnerships, or companies which you have a statutory obligation to honor in the event of certain contingencies and any direct obligations that are not reflected in the balance sheet above that or have you will be required to honor in the event of certain contingencies. These include obligations to Bank of America as well as to other banks or creditors of any kind. You must disclose all such guarantees, endorsements, etc. in this schedule. 1. As Guarantor or Endorser 3. Legal Claims or Judgments 5. Standby Letter of Credit 2. On Leases or Contracts 4. Income Tax Claim or Dispute Amount 6. Other Max. Legal Explanation: Include whether you Type Name of Primary Due To Obligation Maturity anticipate having to honor this Obligor Amount liability. INTO VARIOUS TRANSACTIONS WITH FAMILY TRUSTS AND i — NOTE THAT LEON D. BLACK PURSUANT TO ESTATE PLANNING ENTERED AND PAYABLES BY LEON D. BLACK TO TRANSACTION S GIVE RISE TO RECEIVABLES GRANTOR RETAINED ANNUITY TRUSTS. THESE - INCOME TAX PURPOSES. THESE INTRA-FAMILY TRANSAcTiONS FAMILY GRANTOR TRUSTS FOR WHICH LEON D BALCK IS GRANTOR FOR REPORTING PUONDSES,TH ESE TRANSACTIONS ARE METIER. — FOR - ARE ZERO SUM TRANSACTIONS AS ANY RECEIVABLE IS EQUAL TO A PAYABLE. I Annual Income/Expense Information I I I HAVE NO CONTINGENT LIABILITIES crethi. fraeony, CMd supped or Separate Miasma Immo nod net be tended trims you Wall le Mn tem eeneldered as a bet for nepeng the requesial Last Year Projected This Last Year Projected this 79" 2o/3 Year It Zing Uses of Cash 19_ Year 19_ Sources of Cash Recurring Expenses Salary & Wages Income Taxes & FICA Commissions, Bonus, Etc. Other Payroll Deduction Interest & Dividends living Expense, Misc. Real Estate Income Real Estate Expense Trust Income Planned Investments Other Business Income Alimony, Child Support, Separate Maint. Other. Other. Sub Total Sub Total Non-Recurring Debt Service Commissions, Bonus, Etc. Primary Residence Pmt. Sale of Assets Scheduled Principal & Int Tax Refund Other Interest Pmts. Other Other Principal Pmts. Contingent Liability Pmts. Total Cash Uses Total Cash Sources Total Cash Flow EFTA R1 02000834 EFTA02683504  Pane 3 Schedule 1 - Cash; Deposit Accounts Name on Account Deposit Institution & Location Balance Type of Account Number Pledged? Account Yes/No Total This Bank to Page 2 Total Other Institutions to Page 2 Schedule 2 - Securities; Stocks and 'Restricted' means trading of the Security Is subject to limitations due to letter, legend or eceibot Bonds Name of Issuer Where Traded No. of Mkt Price Market Cost pe Pledged? Restricted Registered in the Name Shares per Share Value Share Yes/No Yes/No of Total Marketable o Page 2 Total Not Publicly Traded to Page 2 Schedule 3 - Accounts Receivable; Notes Receivable Due From Original Amount Present Rate Maturity Payment Terms Collectable? Collateral Balance Yes/No Total to Page 2 Schedule 4 - Life Insurance and Annuities (Including Employer Provided) Company Face Amount Beneficiary Cash Value Policy Loan Net Cash Value Insured Pledged? Yes/No Total to Page 2 Schedule 5 - Deferred Compensation & Retirement Plans (Includes IRA Accounts, KEOGH 401(K) Fully Vested Benefit Plans. etc.) Trustee or Plan Administrator Type of Beneficiary Balance/ Plan Net Plan Value in Name of Account Value Loan Total to Page 2 Schedule 6 - Notes Payable (Exclude Mortgages Listed in Schedules 7 & 8) Due To Original Amount Present Rate Maturity Payment Terms Current? Collateral Balance Yes/No Total to Page 2 "If you are a Co-Make , list the loan in this Schedule and state the Borrower's Name in the Collateral Column. EFTA_R1_02000835 EFTA02683505  For Schedules 7 and 8, if the amount of Debt, which can be legally enforced against you. exceeds your % of ownership, please detail in contingent liability section on Page_ 2. Page A Schedule 7 Real Estate Owned (Including Partnership Interests) # Ownership, Description Year Cost & Market Related Debt (Mark — "by amount if not personally liable) Location, Site, Improvements Acquired Investments Value Present Lienholder Maturity Interest Annual Net Taxes Balance Rate Payments Operating Current? _ Revenue Yes or No Primary Residence Totals to Page 2 Other Wholly Owned Real Estate Totals to Page 2 Partial Ownership in Real Estate % Your Portion of Market Value and Debt Totals to Page 2 Schedule 8 - Other Business Assets (Including Whole & Partial Ownersh p In E ul ment O & a Mineral Interest. etc.) Related Debt (Mark"'" by amount if not persona!), liable) Location, Description, Type of % Year Date of Present Present Lien-holder Maturity Interest Annual Net Taxes Interest & Source of Valuation Acquired Valuation Valuation Balance Rate Payments Operating Current Revenue Yes or No 1 2 3 4 5 "Net Operating Revenue after Operating Expense Totals to Page 2 9£9000ZO-ld-Vid3 EFTA02683506  ADDENDUM TO FINANCIAL STATEMENT Bank of America Certification of Bank of America, N.A. Financial Statement To Bank of America, N.A. Date: The undersigned hereby certifies and represents to Bank of America, N.A. as follows: that the financial and furnished to Bank of information set forth on the financial statement dated respects; that such statement, taken as a America herewith is true, accurate and complete in all material tion as of the date of such statement; whole, presents a fair summary of the undersigned's financial condi undersigned free of any interest or claim of that each of the assets set forth therein is owned by the , and only to the extent of such interest or interest thereto of any other person (except as specifically noted to Bank of America in connection with claimed interest of such other person); that the statement is given America to the undersigned and with an extension of credit granted or requested to be ranted by Bank of ation in deciding to grant or continue to the specific intent that Bank of America shall rely on such inform liens, encumbrances or defects in or upon grant credit to the undersigned; that there exist no undisclosed undersigned; that all taxes owed by the the assets listed herein or any undisclosed liability of the not yet due and payable without penalty, undersigned have been fully paid and discharged, except taxes ents or liens against the undersigned and that there are not pending claims, actions, proceedings, judgm said statement. or any of the undersigned's property, except as fully disclosed in Contingent Liabilities guarantor except those listed below: I (We) have no CONTINGENT LIABILITIES as endorser or NONE (please check, if applicable) If so, my (our) contingent liabilities are: Amt Project Perf Cash Calls Project % Interest X (Signed by all persons whose assets or liabilities appear X on the financial statement) EFTA R1 n9nnnyva7 EFTA02683507