_____________________________________________________________________________________________
Name of Person or Organization                 Statement  Date

		ASSETS					LIABILITIES AND NET WORTH            

	CURRENT ASSETS						CURRENT LIABILITIES

1. Cash/Checking		  _____________	20. Automobile Loan(s)   __________________
2. Savings			  _____________	21. Credit Card Debt(s)  __________________
3. Stocks, Bonds, Mutual Funds	  _____________   	22. Personal Loans	    __________________
	(See note below)			23. Student Loans	     __________________
4. IRA, 401k, Keogh 		  _____________ 	24. Personal Estimated 	 
	(Vested interest)			     Taxes Payable  	     __________________
5. Life Insurance           			25. Real Estate Estimated
 	(Cash surrender value)  _____________	     Taxes Payable	     __________________
6. Accounts Receivable	   _____________	26. Other Estimated	 	
   					     Taxes Payable          __________________
					27. Contingent Liabilities  _________________
					28. _____________________   ___________________	
							

7. Total Current Assets           ______________ 	29. Total Current Liabilities _______________________
FIXED ASSETS							LONG-TERM LIABILITIES								

8. Primary Residence	     	 _______________			Mortgages Payable:
9. Other Residence	   	 ________________	
10.Real Estate-         			30. __________________________  ___________________ 
	Rental Property   	_________________
11.Automobiles		___________________	31. __________________________  ___________________
12.Furniture 		___________________	32. __________________________  ___________________		
13.Collectibles		_________________ 	33. __________________________  ___________________	
14.Antiques		____________________					
15.Jewelry		  	_______________ 	34. Lien(s)		___________________	
16.__________________ 	__________________	35. Personal Loan(s)		___________________
17.__________________	          __________________	36. Student Loans		___________________
					37. Other: (i.e., Insurance	
18.Total Fixed Assets    	_________________         Payable, Accounts Payable,	
						 Chapter 13 Balance	____________________

19.TOTAL ASSETS		  _________________	38. Total Long-Term Liabilities  ____________________    	
	(Add lines 7 and 18)				 
---------------------------------------------	39. TOTAL LIABILITIES	  	______________________
*	MAKING IT EASIER				(Add line 29 and line 38)
1. Definitions of Terms			40. NET WORTH	 	 ______________________ 
2. Value assets at current market value.		(Subtract line 39 from 19)
3. Prepare separate schedules for
   accounts with several items.
4. Information in this statement is for
   your private use. Please do not submit
   this information to Detroit Stock ExchangeŽ  
   Inc., Detroit Stock Investments Co. or Swahili Time.
5. Save as an Excel worksheet

Disclaimer.

Copyright  2006  Detroit Stock ExchangeŽ,  Inc. All Rights Reserved. 08/02/2006

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