Personal Financial Statement 2

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                             (you may want to print this sheet out for ease of reference)

This MS Excel file contains three (3) tabbed worksheets. This is the "Notes" worksheet with instructions on using
the two page "Personal Financial Statement" form included. The other two worksheets are labeled "Page 1" and
"Page 2", referring respectively to the two pages of the Personal Financial Statement form. In preparing the
Personal Financial Statement form, it may be more practical to complete Page 2 of the form first, then carry the
totals over to Page 1 of the form.

This Personal Financial Statement form can be used in two ways: 1. Print out both pages of the form as is (in
blank), then complete the paper form by hand; or, 2. Prepare the form on your PC while in MS Excel, then print out
the completed pages to sign. Either way, be sure to sign and date the completed form.

If you elect to prepare the form on your PC while in MS Excel, the figures you input in the schedules on Page 2
should be automatically totaled for you and carried over to the correct cells in the balance sheet on Page 1 of the
form. Also, when you select "Public" or "Close" in Schedule 2, the correct values should be carried over to lines 3
& 4 in the "Assets Owned" section of the balance sheet on Page 1 of the form. Similarly, when you select "Direct"
or "Cont." and "Type of Debt" in Schedule 6, the correct amounts should be carried over to lines 2 through 7 in the
"Liabilities Owed" section of the balance sheet and line 5 in the "Contingent Liabilities" section on Page 1 of the
form. The "% Owned" of real estate you input in Schedule 5 determines if the value is carried over to line 7 or 8 in
the "Assets Owned" section of the balance sheet on Page 1 of the form. 100% goes to "Wholly Owned Real
Estate", anything less than 100% goes to "Partially Owned Real Estate".

Keep in mind that the "automation" built into the worksheets is not very sophisticated, so be sure to double check
your totals in the schedules on Page 2 of the form and the figures that are carried over to the balance sheet on
Page 1 of the form. If you accidentally overwrite a formula in a cell you may either try to re-create the formula
yourself (adding up columns above the total cell is pretty easy) or open another blank template of the form and copy
the correct formula over to your worksheet.

All three worksheets are "protected". When enabled, this feature allows you to tab back and forth to each cell
available for inputting information without "getting lost" in non-input cells. It also "protects" label and formula cells
from being accidentally altered while inputting your information. The "protection" feature can be turned off and back
on as necessary under the "Tools" menu on the MS Excel toolbar. It is suggested that each worksheet be
protected or unprotected separately, rather than the entire MS Excel workbook file. Also, it is strongly
recommended that you do not input a password when turning the protection back on (when prompted, leave the
space blank) unless you are sure you will remember it.

You can add more lines of information in the schedules on Page 2 of the form by unhiding the hidden rows in
each schedule section, entering the additional information, then re-hiding those excess rows not needed. Figures
from the added rows should be picked up in the "Totals" cells for each schedule. If you need to add many lines, it
may make more sense to change the print orientation from landscape to portrait, so the printed font size is not so

Please open the MS Excel file as a document rather than a template, so when you save your information you will
be prompted to give your new file a unique name and still have the original blank template form for future use.
                                                       PERSONAL FINANCIAL STATEMENT
                                         Provided to MACED as of:                                                                                      (effective date) by:
                    Primary Statement Provider                                                                                        Joint Statement Provider
                                                                                                                (complete if any assets or income listed at full value are owned jointly)
Full Legal                                                                                                     Full Legal
Name                                                                                                           Name
Social                                                                 Date of                                 Social                                                                 Date of
Security #                                                             Birth                                   Security #                                                             Birth
Home Street                                                                            Since                   Home Street                                                                            Since
Address                                                                                Mo./Yr.                 Address                                                                                Mo./Yr.
Home City,                                                             Home                                    Home City,                                                             Home
State & Zip                                                            Phone     (       )                     State & Zip                                                            Phone     (       )
                                                                                       Since                                                                                                          Since
Occupation                                                                                                     Occupation
                                                                                       Mo./Yr.                                                                                                        Mo./Yr.
                                                                                       Since                                                                                                          Since
Employer                                                                                                       Employer
                                                                                       Mo./Yr.                                                                                                        Mo./Yr.
Work Street                                                                                                    Work Street
Address                                                                                                        Address
Work City,                                                             Work                                    Work City,                                                             Work
State & Zip                                                            Phone     (       )                     State & Zip                                                            Phone     (       )
                         Assets Owned                                                        Current                                 Liabilities Owed                     Current
         (exclude any with doubtful value)                                                    Value             (list contingent liabilities in separate section below)   Amount
Cash & Equivalents, non-retirement (from Schedule 1) $                                                         Accounts & Bills Due                                     $

Qualified Retirement Funds (from Schedules 1 & 2)    $                                                         Securities Margin Accounts (from Schedule 6)                                            $

Publicly Traded Securities & Funds, non-retirement (Sched. 2)                           $                      Credit Cards (from Schedule 6)                                                          $

Closely Held Business Interests (from Schedule 2)                                       $                      Lines of Credit, non-real estate (from Schedule 6)                                      $

Cash Surrender Value of Life Insurance (from Schedule 3)                                $                      Loans against Life Insurance (from Schedule 6)                                          $

Vehicles & Equipment (from Schedule 4)                                                  $                      Installment Loans, non-real estate (from Schedule 6)                                    $

Wholly Owned Real Estate (from Schedule 5)                                              $                      Real Estate Secured Loans & Lines (from Schedule 6)                                     $

Partially Owned Real Estate (from Schedule 5)                                           $                      Taxes Owed or Accrued                                                                   $
Notes or Accounts Receivable (detail if >10% of assets)                                 $                      Deferred Taxes on Qualified Retirement Funds                                            $
Household & Personal Property (detail if >10% of assets)                                $                      Deferred Taxes on Unrealized Capital Gains                                              $
       Other Assets & Property (detail below)                                                                     Other Direct Liabilities & Debt (detail below)
                                                                                        $                                                                                                              $
                                                                                        $                                                                                                              $
                              Total Assets:     $                                                                                                        Total Liabilities: $
                    minus Total Liabilities: -. $
                          equals Net Worth: = $                                                                         (please be sure to complete the schedules on page 2)
                   Expenses                                                                          Income                                                       Contingent Liabilities
    Current Payments Annualized                                 Current Annualized Primary Provider                                    Joint Provider              Amount Potentially Liable
Housing Rental (if not owned) $                                Base Salary & Wages $                                                   $                      Pending Lawsuits       $
Housing Utilities                       $                      Commissions & Bonuses $                                                 $                      Contested Taxes        $
Insurance Premiums                      $                      Interest & Investments $                                                $                      Other Disputed Liabilities $
Property Taxes                          $                      Real Estate Rent (net) $                                                $                      Lease Agreements                         $
Income Taxes                            $                      Other Income *         $                                                $                      Contingent Debts (Sched. 6) $
Alimony/Child Support                   $                      Total Income: $                                                  $                              Total Cont. Liabs: $
Vehicle Lease(s)                        $                      Sources of                                                                             Has either Statement                                      Yes:
                                                                                                                                                      Provider ever been
Direct Debts (Sched. 6) $                                      Other Income *
                                                                                                                                                      declared bankrupt or
                                                                                                                                                                                                Q               or
Other: ______________ $                                        Taxes Filed & Paid through:               ______ (year)                  ______ (year) insolvent?                                                No:
Other: ______________ $                                         * Alimony, child support & separate maintenance income does not have If Yes, in which month & year filed: ______
Total Expenses: $                                               to be disclosed unless it is to be considered a basis for repaying credit. County & state filed: _______________

                                      Understanding, Certification, Agreement & Authorization
Each Statement Provider understands that this Financial Statement by itself is NOT an application for credit and must be accompanied by additional information as directed by MACED (the 'Lender') in order to be considered
for credit. The information contained in this Financial Statement, including all Schedules, is hereby provided for the purpose of obtaining or maintaining credit with the Lender on behalf of each Statement Provider, or
persons, groups, or organizations in whose behalf each Statement Provider may either individually, severally, or jointly with others, execute a guaranty in favor of the Lender. Each Statement Provider understands that the
Lender is relying upon the information provided in this Financial Statement, including designations as to ownership of property and liability of debt, in deciding to grant or continue credit.
Each Statement Provider hereby certifies, represents, and warrants that all of the information provided in this Financial Statement is true and complete, and that the Lender may consider this Financial Statement as
continuing to be true and complete until a written notice of a change is given to the Lender by each Statement Provider. As long as a loan or commitment to lend is oustanding, each Statement Provider hereby agrees to
update this Financial Statement for the Lender no less often than annually. Each Statement Provider hereby authorizes the Lender to make all inquiries it deems necessary to verify the accuracy of the information provided
and statements made in this Financial Statement, and to determine the creditworthiness of each Statement Provider. Each Statement Provider also hereby authorizes the Lender to answer questions from and provide
information to other parties about its credit experience with each Statement Provider.

 Signature of Primary Statement Provider: ____________________________________________________                                                                 Date Signed: __________________
 Signature of Joint Statement Provider: ____________________________________________________                                                                   Date Signed: __________________
                                (please complete all sections, including schedules on page 2)                                                                                                           page 1 of 2
 Unhide Rows As Needed                                                                                                                                                                                     Hide Rows Not Needed
                                                                           PERSONAL FINANCIAL STATEMENT
Schedule 1 - Cash Deposits & Equivalents                                                               (SCHEDULES)                                                                       please summarize schedule totals on page 1
            Name of Bank or                           City & State of                          Deposit Ownership                                Type of Deposit                           Total Amount Portion in Qual. Amt. Pledged
          Custodian of Deposits                      Bank or Custodian                         Titled in Name(s) of                 (checking, savings, CD, money market)                   of Deposit Retirement Accts. as Collateral

                                                                                                                                                                                          $                    $
                                                                                                                                                                                          $                    $                detail debt
                                                                                                                                                                                          $                    $                 below in
                                                                                                                                                                                          $                    $                Schedule 6

Schedule 2 - Stocks, Bonds, Funds, Other Securities & Business Interests                                                                                         Totals  $                           $
Name of Issuing Company, Public If Close, Securities or Ownership          Name of Custodian or        Type of Securities or Interest # Shares or            Current                Date & Source of           Portion in Qual. Loan or Margin
  Institution or Agency  or Close? % Owned Interest Titled in Name(s) of    Broker of Securities       (stock, fund, LLC, partn.) $ Face Val.              Market Value              Market Value              Retirement Funds Amount Owed

                            P or C       %                                                                                                                 $                                                   $
                                                                                                                                                                                                                                detail debt
                            P or C       %                                                                                                                 $                                                   $
                                                                                                                                                                                                                                 below in
                            P or C       %                                                                                                                 $                                                   $                Schedule 6
Schedule 3 - Life Insurance                                                                                                   $                           Totals                $
       Name of                  Name of                City & State           Name of                  Name of                Name(s) of         Mo. & Yr. Type of Policy Face Amount Current Cash Current Loan
 Insurance Company          Insurance Agent             of Agent           Person Insured            Policy Owner        Primary Beneficiary(ies) Issued   (term, group) Payable at Death Surrender Value Amount Owed
                                                                                                                                                                                          $                    $
                                                                                                                                                                                                                                detail debt
                                                                                                                                                                                          $                    $
                                                                                                                                                                                                                                 below in
                                                                                                                                                                                          $                    $                Schedule 6
Schedule 4 - Motor Vehicles & Equipment (including water & air craft)                                                                                                       Total           $
        Year &                       Model Name              Type of Vehicle or Craft           Ownership Titled in        Mo. & Yr.            Original              Current             Date & Source of             Pled- Current Loan
      Manufacturer                    or Number               (car, van, truck, boat)              Name(s) of              Purchased             Cost               Market Value           Market Value                ged? Amount Owed
                                                                                                                                           $                        $                                                  Y or N
                                                                                                                                           $                        $                                                  Y or N detail debt
                                                                                                                                           $                        $                                                  Y or N below in
                                                                                                                                           $                        $                                                  Y or N Schedule 6
Schedule 5 - Real Estate (including both wholly & partially owned property)                                              * list at % owned                     $                     Total         HEBJC
       Street Address              City & State           Type of Property        %             Ownership Titled in        Mo. & Yr.           * Original           * Current (%)      Date & Source of            * Mo. (%) Current Loan
         of Property               of Property          (home, rental, com'l)    Owned             Name(s) of              Purchased           (%) Cost             Market Value        Market Value               Rental Inc. Amount Owed
                                                                                        %                                                  $                        $                                              $
                                                                                                                                                                                                                                detail debt
                                                                                        %                                                  $                        $                                              $
                                                                                                                                                                                                                                 below in
                                                                                        %                                                  $                        $                                              $            Schedule 6
Schedule 6 - Debts Owed Directly (as borrower) or Contingently (as co-signer, guarantor, or endorser)                                                           $                       Totals               $
         Name of                City & State      Direct          Debt Owed in              Mo. & Yr. Term       Credit Limit or      Type of Debt                      Purpose               Collateral           Monthly        Current
         Lender                  of Lender        Cont.?           Name(s) of               Originated in Yrs.   Original Amt.     (mortg., instal., cr.card)           of Debt               Pledged              Payment      Amount Owed
                                                  D or C                                                         $                                                                                                 $            $
                                                  D or C                                                         $                                                                                                 $            $
                                                  D or C                                                         $                                                                                                 $            $
                                                  D or C                                                         $                                                                                                 $            $
                                                  D or C                                                         $                                                                                                 $            $
                                                  D or C                                                         $                                                                                                 $            $
              D or C                       $                                    $   $
              D or C                         $                                  $   $
page 2 of 2            please attach additional sheets as needed   Totals  $       $

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