Assignment 7

Be Well and Stay Safe!

This soon will pass!

Year12345

Product Sales4,000,000$ 5,000,000$ 7,500,000$ 9,375,000$ 11,718,750$

Profssional Services500,000$ 625,000$ 781,250$ 976,563$ 1,220,703$

Managed Services100,000$ 125,000$ 156,250$ 195,313$ 244,141$

Rebates50,000$ 62,500$ 78,125$ 97,656$ 122,070$

MDF25,000$ 31,250$ 39,063$ 48,828$ 61,035$

Total Revenue4,675,000$ 5,843,750$ 8,554,688$ 10,693,359$ 13,366,699$

Cost of Goods Sold3,400,000$ 4,250,000$ 5,312,500$ 6,640,625$ 8,300,781$

Gross Profit1,275,000$ 1,593,750$ 3,242,188$ 4,052,734$ 5,065,918$

Overhead

Admin/Exec450,000$ 562,500$ 703,125$ 878,906$ 1,098,633$

Engineering300,000$ 375,000$ 468,750$ 585,938$ 732,422$

Man Services250,000$ 312,500$ 390,625$ 488,281$ 610,352$

Sales300,000$ 375,000$ 468,750$ 585,938$ 732,422$

Sales Support150,000$ 187,500$ 234,375$ 292,969$ 366,211$

Total Overhead1,450,000$ 1,812,500$ 2,265,625$ 2,832,031$ 3,540,039$

Operatng EBITDA(175,000)$ (218,750)$ 976,563$ 1,220,703$ 1,525,879$

Capital Expenditures(500,000)$ (250,000)$ (100,000)$ (100,000)$ (100,000)$

Cash Needed(675,000)$ (468,750)$ 876,563$ 1,120,703$ 1,425,879$

PERSONAL FINANCIAL STATEMENT AS OF ______________

SUBMITTED TO:

PERSONAL INFORMATION

APPLICANT (NAME)

CO-APPLICANT (NAME)

Employer

Employer

Address of Employer

Address of Employer

Business Phone No.

No. Of Years with

Employer

Title/Position

Business Phone No. No. of Years with Title/Position

Name of previous employer & position (if above is less than 3 yrs.) No. of Yrs. Name of previous employer & position (if above is less than 3 yrs.) No. of Yrs.

Home Address

Home Address

Home Phone No.

Cell Phone No. Date of Birth

Home Phone No. Cell Phone No. Date of Birth

Email Address: Social Security No.

Email Address: Social Security No.

Name, Phone No. of your Accountant

Name, Phone No. of your Accountant

Name, Phone No. of your Attorney

Name, Phone No. of your Attorney

Name, Phone No. of your Investment Advisor/Broker Name, Phone No. of your Investment Advisor/Broker

Name, Phone No. of your Insurance Advisor Name, Phone No. of your Insurance Advisor

Cash Income & Expenditures Statement For Year Ended (Omit cents)

ANNUAL INCOME AMOUNT ($) ANNUAL EXPENDITURES AMOUNT ($)

Salary (applicant) $ Federal Income and other taxes $

Salary (co-applicant) State Income and other taxes

Bonuses & Commissions (Applicant) Rental Payments, Co-op, or Condo Maintenance

Bonuses & Commissions (co-applicant) Mortgage payments Residential

Investment

Rental Income Property Taxes Residential

Investment

Interest Income Interest & Principal Payments on Loans

Dividend Income Insurance

Capital Gains Investments (including tax shelters)

Partnership Income Alimony/Child Support

Other Investment Income Tuition

Other Income (List)** Other Living Expenses

Medical

Other Expense (List)

TOTAL INCOME 

$

TOTAL EXPENDITURES 

$

Any significant changes expected in the next 12 months?  Yes  No (If yes, attach information).

** Income from alimony, child support, or separate maintenance income need not be revealed if the applicant or co-applicant does not

wish to have it considered as a basis for repaying this obligation.

Balance Sheet as of ______________________

ASSETS AMOUNT ($) LIABILITIES AMOUNT ($)

Cash in this Bank

(Including money market accounts, CDs)

$

Notes Payable to this Bank

X X X

Secured

$

Cash in Other Financial Institutions (List)

(including money market accounts, CDs)

Unsecured

Notes Payable to Others (Schedule E)

X X X

Secured

Unsecured

Accounts Payable (including credit cards)

Margin Accounts

Readily Marketable Securities (Schedule A) Notes Due: Partnership (Schedule D)

Non-Readily Marketable Securities (Schedule A) Taxes Payable

Accounts and Notes Receivable Mortgage Debt (Schedule C)

Net Cash Surrender Value of Life Insurance (Schedule B) Life Insurance Loans (Schedule B)

Residential Real Estate (Schedule C) Other Liabilities (List):

Real Estate Investments (Schedule C)

Partnerships / PC Interests (Schedule D)

IRA, Keogh, profit-sharing & Other Vested Retirement

Accts.

Deferred Income (number of years deferred_____)

Personal Property (including automobiles)

Other Assets (List):

TOTAL LIABILITIES

NET WORTH

$

$

CONTINGENT LIABILITIES YES NO AMOUNT

Are you a guarantor, co-maker, or endorser for any debt of an individual,

corporation, or partnership





$______________________

Do you have any outstanding letters of credit or surety bonds?

 

$______________________

Are there any suits or legal actions pending against you?

 

$______________________

Are you contingently liable on any lease or contract?

 

$______________________

Are any of your tax obligations past due?





$______________________

What would be your total estimated tax liability if you were to sell your major

assets?

$____________________

If yes for any of the above, give details:

SCHEDULE A – ALL SECURITIES (including non -money market mutual funds)

No. of Shares

(Stock) or Face

Value (Bonds)

DESCRIPTION

OWNER(S)

WHERE HELD

COST

CURRENT

MARKET VALUE

PLEDGED

YES NO

READILY MARKETABLE SECURITIES (including U.S. Governments and Municipals)*

 

 

 

 

NON-READILY MARKETABLE SECURITIES (closely held, thinly traded, or restricted stock)

 

 

* If not enough space, attach a separate schedule or brokerage statement and enter totals only.

Schedule B – Insurance

Life Insurance (Use additional sheet if necessary)

Insurance Company

Face Amount of

Policy

Type of Policy

Beneficiary

Cash Surrender

Value

Amount Borrowed

Ownership

Disability Insurance Applicant Co-Applicant

Monthly Distribution if Disabled

Number of Years Covered

Schedule C – Personal Residence & Real Estate Investments, Mortgage Debt (majority ownership only)

Personal Residence

Property Address

Legal Owner

Purchase

Market

Value

Present

Loan

Balance

Interest

Rate

Loan

Maturity

Date

Monthly

Payment

Lender

Year Price

Investment

Property Address

Legal Owner

Purchase

Market

Value

Present

Loan

Balance

Interest

Rate

Loan

Maturity

Date

Monthly

Payment

Lender

Year Price

Schedule D – Partnerships (less than majority ownership for real estate partnerships)*

Type of Investment

Date of Initial

Investment

Cost

Percent

Owned

Current Market Value

Balance Due on

Partnerships: Notes,

Cash Call

Final

Contribution

Date

Business/Professional (indicate name):

Investments (Including Tax Shelters):

* NOTE: For investments which represent a material portion of your total assets, please include the relevant financial statements or

tax returns, or in the case of partnership investments or S -corporations, Schedule K-1S.

Schedule E – Notes Payable

Due to

Type of Facility

Amount of Line

Secured

Collateral

Interest

Rate

Maturity

Unpaid

Balance

Yes No

 

 

 

Representations, Warranties and Authorizations:

This personal statement is provided to the Bank in support of an applicati on for (check one):

 Individual Business Credit (applicant);

 Joint Business Credit (applicant/co -applicant);

 Personal Guarantee of the business obligations of another person or entity

The information contained in this statement is provided to induc e you to extend or to continue the extension of credit to the undersigned or to others

upon the guarantee of the undersigned. The undersigned acknowledge and understand that you are relying on the information pro vided herein in

deciding to grant or continue credit or to accept a guarantee thereof. Each of the undersigned represents, warrants and certifies that the information

provided herein is true, correct and complete. Each of the undersigned agrees to notify you immediately and in writing of an y change in name, address,

or employment and of any material adverse change (1) in any of the information contained in this statement or (2) in the fina ncial condition of any of

the undersigned or (3) in the ability of any of the undersigned to performed its (or t heir) obligations to you. In the absence of such notice or a new and

full written statement, this should be considered as a continuing statement and substantially correct. If the undersigned fa il to notify you as required

above, or if any of the information herein should prove to be inaccurate or incomplete in any material respect, you may declare the indebtedness of the

undersigned or the indebtedness guaranteed by the undersigned, as the case may be, immediately due and payable. You are auth orized to make all

inquiries you deem necessary to verify the accuracy of the information contained herein and to determine the credit -worthiness of the undersigned. The

undersigned authorize any person or consumer reporting agency to give you any information it may have on the undersigned. Each of the undersigned

authorizes you to answer questions about your credit experience with the undersigned. As long as any obligation or guarantee of the undersigned to you

is outstanding, the undersigned shall supply annually an updated financial statement. This personal financial statement and any other financial or other

information that the undersigned give you shall be your property.

Notice Regarding USA Patriot Act: The Bank complies with Section 326 of the USA Patriot Act. This law mandates that we obtain and verify

certain information about you, including your name, legal address, date of birth and social security or tax identification nu mber, while processing your

account application. You will be required to provide a copy of your driver’s license or other government issued photo ID.

Notice of Right to Receive Appraisal Copy: The Bank may order an appraisal in connection with your loan request and charge you for this appraisal.

We will promptly give you a copy of an y appraisal, even if your loan does not close. You can pay for an additional appraisal for your own use at your

own cost.

Date Applicant/Guarantor’s Signature

Date Co-Applicant/Guarantor’s Signature

(if you are requesting the financial accommodation jointly)