EFTA02683508.pdf

Bank of America Confidential Personal Financial Statement/Certification as of 2./3 ill 4/ The assets, liabilities, income and expenses described on this (or the attached) financial statement are (check the appropriate box): 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 fist all of your direct and contingent liabilities. D 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. 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. Are 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. Are any of the assets fisted 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 overfeed 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 Yes No 11. Are you an officer, director, or principal shareholder of a financial Institution? or contested? (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 ddltional Remarks undersigned (I:We) herewith submit to Bank of America (you) this (or the attached) financial and supporting schedules which constitute my (our) personal ncial 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 redly as guarantor(s) or other indirect obligor(s) of credit extended to Others. I (we) hereby certify that this statement presents a hue, complete, and ect statement of my (our) financial condition as of the date shown and does not omit any pertinent information. I (we) understand that misrepresenting ration on this (or the attached) statement is a criminal offense under federal law. *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 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 'nal statement of my (our) financial condition at the time I (we) request such further credit. You are hereby authorized to contact credit reporting agencies other sources for the purpose of verifying any information stated herein or at any time are authorized to answer any questions about your credit Mence with me (us), and fumish to Bank of America or any of its subsidiaries information which I (we) have provided to you and information regarding any y (our) accounts. ature Date Signature Date EFTA_R1_02000838 EFTA02683508  in ace' Balance Sheet Page 2 Assets (omit cents) LiabRities (omit cents) Cash In this Bank Mortgages Pdmary Residence (Schedule 1) In Other Institutions Payable Oth Wholly-Owned RE Securities Marketable (Schedule 7) Partially Owned RE (Schedule 2) Not Publicly Traded Notes To this Bank Accounts Receivable/Notes Receivable (Sch. 3) Payable Other Notes Payable Net Cash Value Ins. & Annuities (Schedule 4) (Schedule 6 & 8) Margin Account Real Printery Residence Taxes Income Taxes Estate Other Wholly-Owned RE 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) Total Liabilities Net Worth (Assets Less Liabilities) Iieuucuuus. arare rorar amount by 1ype of Liability andProvide Appropriate DetailIn The Space Below. Contingent liabilities are financial obligations of other individuals, partnerships, or companies which you have endorsed, guaranteed or otherwise agreed to or 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 you will be required to honor in the event of certain contingencies. These include obligations to Bank of any kind. You must disclose all such guarantees, endorsements, etc. in this schedule. America as well as to other banks or creditors of 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 e ..... anticipate having to honor this Obit! or Amount lability. I i , i - .. — [NOTE THAT LEON D. BLACK PURSUANT TO ESTATE PLANNING ENTERED INTO VARIOUS TRANSACTIONS WITH FAM LY TRUSTS AND • GRANTOR RETAINED ANNUITY TRUSTS. THESE TRANSACTIONS GIVE RISE TO RECEIVABLES AND PAYABLES BY LEON D. BLACK TO FAMILY GRANTOR TRUSTS FOR WHICH LEON D. BLACK IS GRANTOR FOR INCOME TAX PURPOSES. 711ESONTRA.FAMILY TRANSACTIONS - ARE ZERO SUM TRANSACTIONS AS ANY RECEIVABLE IS Et:WALT° A PAYABLE. FOR REPORTING PURPOSES. THESE TRANSACTIONS ARE NETTED. • t i ' 'I i I HAVE NO CONTINGENT LIABILITIES knnual Income/Expense Information renany. Child support or Separate Maltnanise Income need not be revealed unless yourash to hay them considered as a bias forrepafdtg the requested am% Last Year Projected This Last Year Projected this sources of Cash 19_ Year 19_ Uses of Cash 19_ Year 19._ Meaning Expanses alary & Wages Income Taxes & FICA :ommissions, Bonus, Etc. Other Payroll Deduction Retest & Dividends Living Expense, Misc. eat Estate Income Real Estate Expense rust Income Planned Investments ther Business Income Alimony, Child Support, Separate Maid. then Other: Sub Total Sub Total on-Recurring Debt Service ommissions, Bonus, Etc. Primary Residence Pmt. ate of Assets Scheduled Principal & Int. IX Refund Other Interest Pmts. ther Other Principal Pmts. Contingent Liability Pmts. Total Cash Uses Total Cash Sources Total Cash Flow EFTA_R1_02000839 EFTA02683509 EFTA_R1_02000840 EFTA02683510