Professional Documents
Culture Documents
BORROWER
___ (is)___ (is not) jointly engaged as a principal in the farming operation described in this statement.
Name(s) of other principal(s) and their relationship to the Borrower, if any, are:_____________________________________________
Borrower agrees to promptly notify lender in writing of any change in the principals engaged in the farm opeation.
NO. DEPENDENTS_________ AGES ____________ BIRTHDATE ________________ OFF FARM EMPLOYMENT___________________
DATE_________________ TO: (Bank) Clear Lake Bank and Trust Company
PHONE__________________________
ASSETS
CURRENT ASSETS
Cash-Checking Acct.
Savings & C.D.'s
Accts.-Notes Rec.
Cash Value Life Ins. (Schedule D)
Livestock Held for Sale (Schedule A)
Grain & Feed on hand (Schedule B)
LIABILITIES
CURRENT LIABILITIES
Sealed Grain
P.D. Fert.
Payable to Relatives
Payable to Others
Elevator
Chem Co.
Mach. Dealer
Gas
ASCS
Trading Accts.
Stocks, Bonds (Schedule E)
RE Taxes Payable
Income Taxes Payable
Part Inter. Debt. Due
Other
Other
$
$
Breeding Stock
Other
TOTAL INTERMEDIATE ASSETS
LONG TERM OR FIXED ASSETS
Farm Real Estate (Schedule C)
$
$
Workers Compensation
Yes
No
YES
NO
NO
Insurance on Crops
YES
YES NO
Estate Plan?
$
YES NO
Number
Total
TOTAL
Acres Crops Growing on Or To Be Grown
Crop
Acres
Pr/Ut.
Value
TOTAL
Cost
Value
Encumbrances
Due Date
Rate
Mortgagee
Cost
Value
Encumbrances
Due Date
Rate
Mortgagee
Face Value
Location/Description
Mkt Value
Value
Value
Year
Kind
TOTAL
Cost
The information contained in this statement is provided for the purpose of obtaining, or maintaining credit with you on behalf of the undersigned, or persons,
firms or corporations in whose behalf the undersigned may either severally or jointly with others execute a guaranty in your favor. Each undersigned
understands that you are relying on the information provided herein (including the designation made as to ownership of property) in deciding to grant or
continue credit. Eash undersigned represents and warratns that the information provided is true and complete and that you may consider this statement
as continuing to be true and correct until written notice of a change is given to you by the undersigned. You are Authorized to make all inquiries you deem
necessary to verify the accuracy of the statements made herein, and determine my/our creditworthiness. You are authorized to answer questions about your
credit experience with me/us.
DATE:
Bank Officer:______________________________
Signature:
Signature: