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401K and Cash Balance Product Sheet - Excel

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401K and Cash Balance Product Sheet document sample

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									                                                           OLD NATIONAL BANK
                                                     AGRICULTURAL CREDIT APPLICATION

A complete application consists of the following information as indicated:                                              As of :
        Signed Agricultural Financial Statement and Agricultural Financial Statement Supporting Schedules
        Signed Complete Federal Income Tax Return(s), and all supporting schedules, for the last three years. (Do not resubmit returns already on file with the bank.)
        Signed Detailed Monthly Agricultural Cash Flow Projection
        Signed Authorization to Release Financial Information



If you intend to apply for joint credit, please initial here.    Applicant__________           Co-Applicant__________

This application is being completed for the following purpose:
        New customer requesting credit
        Current customer requesting additional credit
        Current customer submitting information necessary to maintain existing credit facilities


Applicant:                                                                             Co-Applicant:
Address:                                                                               Address:


Phone #:                                                                               Phone #:
Tax ID #:                                                                              Tax ID #:
Date of Birth:                                                                         Date of Birth:
Applicant is a:    (circle one)                                                        Applicant is a:   (circle one)
      Individual             Partnership                Corporation                      Individual                 Partnership            Corporation
Non-Farm Employment If Applicable:                                                     Non-Farm Employment If Applicable:
Employer:                                                 Start Date:                  Employer:                                             Start Date:

CONTINGENT LIABILITIES
Describe and provide the amount of all contingent liabilities for which you are liable such as financial instruments on which you are an endorser, co-maker or
guarantor, lawsuits and other legal actions, and any other special debts on behalf of other parties.




OTHER INFORMATION
YES     NO
              Do you have a will? If yes, provide the name of the executor:

              Are you a partner or officer in any other venture? If yes, provide information

              Are you obligated to pay alimony, child support, or separate maintenance payments? If yes, provide details on a separate attachment.

              Are any assets pledged other than as described on the schedules? If yes, provide details on a separate attachment.

              Are you a defendant in any suits or legal actions? If yes, provide details on a separate attachment

              Have you ever been declared bankrupt? If yes, provide details on a separate attachment.

              Are all assets adequately covered by insurance? If yes, provide the name of the insurance company:

              Have all required income tax returns been filed and have all tax payments been made? If no, provide details on a separate attachment

The information contained in this application and all supporting schedules is provided for the purpose of obtaining, or maintaining credit with Old National Bank
(hereinafter referred to as "Bank") 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 Bank's favor. Each undersigned understands that Bank is relying on the information provided herein ( including the designation
made as to ownership of property) in deciding to grant or continue credit. Each undersigned represents and warrants that the information provided is true and
complete and that Bank may consider this statement as continuing to be true and correct until a written notice of change is given to Bank by the undersigned. Bank
is authorized to make all inquiries it deems necessary and to obtain credit reports from any credit reporting agency to verify the accuracy of the statements made
herein, in connection with Bank's preliminary evaluation of undersigned, or during any periodic review of undersigned deemed necessary by Bank. Bank is
authorized to answer questions about its credit experience with me / us.


Signature:                                                                                                                 Date:

Signature:                                                                                                                 Date:

Signature:                                                                                                                 Date:

Signature:                                                                                                                 Date:




      Revised 01/05                                             Agricultural Credit Application, Page 1 of 15
Schedule 1 - Cash on Hand and in Banks (Excluding Retirement Accounts)
                                                Account                                                Tot. Cur.   Pledged
         Financial Institution                   Type                      Held In Name Of             Mkt. Val.   On Notes




Total Cash on Hand and in Banks                                                                                0
                                      Record this amount on the Ag Financial Statement - Line 1




Schedule 2 - Marketable Securities (Excluding Retirement Accounts)
                                            #                                                                      Tot. Cur.     Pledged
         Security Description          Shares             Shares Held By              Held In Name Of              Mkt. Val.     On Notes




Total Marketable Securities                                                                                                  0
                                                     Record this amount on the Ag Financial Statement - Line 2




Schedule 3 - Retirement Accounts (IRA, Pension, 401K, etc.)
                                                                                                                   Tot. Cur.     Pledged
            Account Type                         Account Held By                      Held In Name Of              Mkt. Val.     On Notes




Total Retirement Accounts                                                                                                    0
                                                   Record this amount on the Ag Financial Statement - Line 19




Schedule 4 - Life Insurance Investments Including Cash Surrender Values
                                                                                                                                  Gross               Net
                                                                                                                    Face          Cash      Policy    Cash        Pledged
      Insurance Company Name                      Policy Owner                           Beneficiary               Amount         Value     Loans     Value       On Notes
                                                                                                                                                              0
                                                                                                                                                              0
                                                                                                                                                              0
                                                                                                                                                              0
                                                                                                                                                              0
Total Cash Surrender Value Life Insurance                                                                                                                     0
                                                                                         Record this amount on the Ag Financial Statement - Line 11




                                                           Agricultural Financial Statement Supporting Schedules, Page 2 of 15
Schedule 5 - Unrealized Gains (Losses) on Futures & Options
                                                                                                Premium                    Current
                                        Futures         Long                                      Or                      Premium
                                          OR             Or             #       Contract        Contract        Total        Or        Current
                                        Option         Short            of       Futures         Price         Contract   Mkt. Price    Mkt.          Gain         Pledged
             Commodity                  (F,O)         (L,S)         Contracts    Month             $           Amount         $         Value         (Loss)       On Notes




Total Unrealized Gains (Losses) on Futures & Options                                                                                                           0
                                                                                Record this amount on the Ag Financial Statement - Line 4




Schedule 6 - Accounts Receivable - Government
                                                                    Crop Yr.
                                               Security or          Payment     Expected         Total
                                         Purchase Money              Accrues     Receipt        Balance        Pledged
             Due From:                      Description                To         Date            Due          On Notes




Total Accounts Receivable - Government                                                                     0
                           Record this amount on the Ag Financial Statement - Line 3




Schedule 7 - Accounts Receivable - Other
                                                                                                                 Aging Schedule                      Extended Payment
                                               Security or           Original                    Under                    90 Days       Total           Arrangements
                                         Purchase Money               Due        Original         30           30 to 89     and        Balance       Payment       Payment    Pledged
             Due From:                      Description               Date      Balance          Days           Days        Over        Due          Amount        Frequency On Notes
                                                                                                                                                 0
                                                                                                                                                 0
                                                                                                                                                 0
                                                                                                                                                 0
Total Accounts Receivable - Other                                                                                                                0
                                                                   Record this amount on the Ag Financial Statement - Line 10




Schedule 8 - Livestock Held For Sale
                                           #          Average          Unit     Tot. Cur.       Pledged
             Description                 Head         Weight        Mkt. Val.   Mkt. Val.       On Notes




Total Livestock Held For Sale                                                               0
                Record this amount on the Ag Financial Statement - Line 5




                                                             Agricultural Financial Statement Supporting Schedules, Page 3 of 15
Schedule 9 - Breeding or Production Livestock
                                             #        Average         Unit      Tot. Cur.   Pledged
             Description                  Head        Weight        Mkt. Val.   Mkt. Val.   On Notes
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
Total Breeding or Production Livestock                                                  0
               Record this amount on the Ag Financial Statement - Line 13




Schedule 10 - Grain and Forage Held For Resale
                                             #         Unit           Unit      Tot. Cur.   Pledged
             Description                   Units      Measure       Mkt. Val.   Mkt. Val.   On Notes
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
Total Grain and Forage Held For Resale                                                  0
                Record this amount on the Ag Financial Statement - Line 6




Schedule 11 - Grain and Forage Held As Feed
                                             #         Unit           Unit      Tot. Cur.   Pledged
             Description                   Units      Measure       Mkt. Val.   Mkt. Val.   On Notes
                                                                                        0
                                                                                        0
                                                                                        0
                                                                                        0
Total Grain and Forage Held as Feed                                                     0
                Record this amount on the Ag Financial Statement - Line 7




Schedule 12 - Investment in Growing Crops
                                          Acres       Invest.       Pledged
             Description                 Planted      @ Cost        On Notes




Total Investment in Growing Crops                               0
   Record this amount on the Ag Fin. Stmt. - Line 8




                                                         Agricultural Financial Statement Supporting Schedules, Page 4 of 15
Schedule 13 - Prepaid Expenses and Supplies On Hand
                           Description                                  Value




Total Prepaid Expenses and Supplies On Hand                                            0
                Record this amount on the Ag Financial Statement - Line 9




Schedule 14 - Other Current Assets
                                           #         Unit        Unit       Tot. Cur.      Pledged
             Description                 Units     Measure      Value       Mkt. Val.      On Notes
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
                                                                                       0
Total Other Current Assets                                                             0
              Record this amount on the Ag Financial Statement - Line 12




Schedule 15 - Farm Machinery, Equipment, and Vehicles Held Under Capital Leases
                                                                                Year                  Book     Tot. Cur.      %      Pledged
             Description                 Year        Make       Model       Acquired         Cost     Value    Mkt. Val.     Owned   On Notes




Total Farm Machinery, Equipment and Vehicles Held Under Capital Leases                                                 0
                                                  Record this amount on the Ag Financial Statement - Line 14




                                                       Agricultural Financial Statement Supporting Schedules, Page 5 of 15
Schedule 16 - Farm Machinery, Equipment, and Vehicles Owned
                                                                         Year                    Book        Tot. Cur.     %      Ownship      Pledged
            Description               Year       Make        Model     Acquired      Cost        Value       Mkt. Val.    Owned    Share       On Notes
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
                                                                                                                                           0
Total Farm Machinery, Equipment and Vehicles Owned                                                                   0                     0
                                                          Record this amount on the Ag Financial Statement - Line 15




Schedule 17 - Farm Machinery, Equipment, and Vehicles Held Under Operating Leases
                                                                         Date      Expiration   Payment      Payment
            Description               Year       Make        Model     Acquired      Date       Amount       Frequency




Total Farm Machinery, Equipment and Vehicles Held Under Operating Leases                                 0
                                   Record this amount on the Ag Financial Statement - Line 21




                                                    Agricultural Financial Statement Supporting Schedules, Page 6 of 15
Schedule 18 - Farm Real Estate Owned (Undivided Interest)
                                      Tillable       Tillable    Non-tillable Non-tillable Improved    Improved      Total       Tot. Cur.    Pledged
        Description / Location         Acres         Mkt. Val.     Acres       Mkt. Val.     Acres     Mkt. Val.     Acres       Mkt. Val.    On Notes
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0

Total Farm Real Estate Owned -
Undivided Interest                               0     #DIV/0!                                                                            0
                                                                 Record this amount on the Ag Financial Statement - Line 16




Schedule 19 - Farm Real Estate Owned (Partial Interest)
                                                                                 Undivided Total                                                 Partial Totals
                                      Tillable       Tillable    Nontillable Non-tillable Improved     Improved      Total       Tot. Cur.       %       Mkt. Val.     Pledged
        Description / Location         Acres         Mkt. Val.     Acres       Mkt. Val.     Acres     Mkt. Val.     Acres       Mkt. Val.     Owned      Owned        On Notes
                                                                                                                             0            0                        0
                                                                                                                             0            0                        0
                                                                                                                             0            0                        0
                                                                                                                             0            0                        0
                                                                                                                             0            0                        0
                                                                                                                             0            0                        0
                                                                                                                             0            0                        0

Total Farm Real Estate Owned
(Partial Interest)                               0     #DIV/0!                                                                                                     0
                                                                                           Record this amount on the Ag Financial Statement - Line 17




Schedule 20 - Farm Real Estate Leased
                                      Tillable       Annual      Nontillable   Annual      Improved     Annual       Total       Annual        Lease              Lease           Lease
    Property Description / Landlord    Acres          Rents        Acres        Rents        Acres       Rents       Acres        Rents        Type               Terms           Expires
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0
                                                                                                                             0            0


Total Farm Real Estate Leased                    0                                                                                        0




                                                         Agricultural Financial Statement Supporting Schedules, Page 7 of 15
Schedule 21 - Non- Farm Real Estate Owned
                                           Date                      Tot. Cur.      %            Mkt. Val.       Pledged
        Description / Location           Acquired        Cost        Mkt. Val.    Owned           Owned          On Notes:
                                                                                                             0
                                                                                                             0
                                                                                                             0
                                                                                                             0
                                                                                                             0
Total Non-Farm Real Estate Owned                                                                             0
                            Record this amount on the Ag Financial Statement - Line 18




Schedule 22 - Personal and Other Non-Current Assets
                                            #            Unit           Unit     Tot. Cur.       Pledged
             Description                  Units        Measure         Value     Mkt. Val.       On Notes:
                                                                                             0
                                                                                             0
                                                                                             0
                                                                                             0
                                                                                             0
                                                                                             0
                                                                                             0
                                                                                             0
Total Personal and Other Non-Current Assets                                                  0
               Record this amount on the Ag Financial Statement - Line 20




Schedule 23 - Accounts Payable
                                                                                                                   Aging Schedule                        Extended Payment
                                                Security or                                       Under                      90 Days         Total         Arrangements
                                           Purchase Money              Due        Original          30           30 to 89     and          Balance       Payment    Payment     Accrued
           Vendor / Payee                    Description               Date      Balance           Days            Days       Over           Due         Amount     Frequency   Interest
                                                                                                                                                     0
                                                                                                                                                     0
                                                                                                                                                     0
                                                                                                                                                     0
                                                                                                                                                     0
                                                                                                                                                     0
Total Accounts Payable                                                                                                                               0
                                        Combine with Schedule 26 and record total on the Ag Financial Statement - Line 22




Schedule 24 - Operating Lines and Other One Year Notes
                                           Credit Type and             Note       Maturity        Original        Current    Payment       Payment       Accrued
              Creditor                  Collateral Description         Date        Date          Balance         Balance     Amount        Frequency     Interest




Total Operating Lines and Other One Year Notes                                                                                         0
                                                      Record this amount on the Ag Financial Statement - Line 23




                                                              Agricultural Financial Statement Supporting Schedules, Page 8 of 15
Schedule 25 - Other Current Liabilities
                                           #            Unit        Unit         Total         Accrued
              Description                 Units     Measure        Value       Amt. Due        Interest
                                                                                           0
                                                                                           0
                                                                                           0
                                                                                           0
                                                                                           0
                                                                                           0
Total Other Current Liabilities                                                            0
               Record this amount on the Ag Financial Statement - Line 24




Schedule 26 - Credit Card Debt
                                       Is A Principal Balance                                                 Prin. Bal.
                                        Carried From Month       Avg. Mo.        Total         Avg. Yrly       Beyond        Accrued
               Creditor                     To Month?            Payment       Amt. Due        Payment        12 Months      Interest
                                                                                                          0
                                                                                                          0
                                                                                                          0
                                                                                                          0
                                                                                                          0
Total Credit Card Debt                                                     0               0              0              0
    Combine with Schedule 23 and record total on the Ag Financial Statement - Line 25
                                      Record this amount on the Ag Financial Statement - Line 28




Schedule 27 - Long Term Loans and Capital Lease Obligations                                                                                                            Portion of Principal Due
                                            Credit Type                                                                                                  Payment         Within      Beyond
                                                  and              Note         Maturity       Original        Current       Payment         Payment     Within 12         12          12         Accrued
               Creditor                Collateral Description      Date          Date          Balance         Balance       Amount         Frequency     Months         Months      Months       Interest
                                                                                                                                                                   0                          0
                                                                                                                                                                   0                          0
                                                                                                                                                                   0                          0
                                                                                                                                                                   0                          0
                                                                                                                                                                   0                          0
                                                                                                                                                                   0                          0
                                                                                                                                                                   0                          0
Total Long Term Loans and Capital Lease Obligations                                                                                                                0                          0
                                                                               Record this amount on the Ag Financial Statement - Line 26
                                                                                                              Record this amount on the Ag Financial Statement - Line 29




Schedule 28 - Other Long Term Liabilities                                                                                                   Portion of Principal Due
                                                                                                                             Payment          Within      Beyond
                                           #            Unit        Unit         Total         Payment        Payment        Within 12          12          12          Accrued
              Description                 Units     Measure        Value       Amt. Due        Amount         Frequency       Months          Months      Months         Interest
                                                                                                                                        0                          0
                                                                                                                                        0                          0
                                                                                                                                        0                          0
Total Other Non-Current Liabilities                                                                                                     0                          0
                                                   Record this amount on the Ag Financial Statement - Line 27
                                                                               Record this amount on the Ag Financial Statement - Line 30




                                                          Agricultural Financial Statement Supporting Schedules, Page 9 of 15
ANNUAL CROP AND OTHER FARM PRODUCT PRODUCTION SUMMARY AND PROJECTION
                                                                      PROJECTED                                                                    Prior Year 1                                                                 Prior Year 2
                                               Acres       Production                                                   Acres       Production                                                       Acres       Production
                                             Farmed or        Per         Total       Average             Total       Farmed or        Per             Total       Average             Total       Farmed or        Per             Total       Average             Total
                                   Crop      Production      Base         Units       Price Per       Mkt. Val.       Production       Base            Units       Price Per       Mkt. Val.       Production       Base            Units       Price Per       Mkt. Val.
                                     or        Base           Unit       Produced          Unit       Produced          Base           Unit          Produced          Unit        Produced          Base           Unit          Produced          Unit        Produced
      Property Description        Product        #             #            #             $0.00           $000            #              #               #             $0.00           $000            #              #               #             $0.00           $000
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
                                                                                  -                   $           -                                            -                   $           -                                            -                   $           -
Total Crop and Other Production                                                                       $           -                                                                $           -                                                                $           -




ANNUAL LIVESTOCK PRODUCTION SUMMARY AND PROJECTION
                                                          PROJECTED                                                                Prior Year 1                                                                 Prior Year 2
                                              Average                    Average                                       Average                        Average                                       Average                        Average
                                   Total      Weight         Total        Price           Total           Total        Weight          Total           Price           Total           Total        Weight          Total           Price           Total
                                   Head         Per         Weight         Per        Mkt. Val.           Head           Per          Weight            Per        Mkt. Val.           Head           Per          Weight            Per        Mkt. Val.
                                  Produced     Head        Produced         lb.       Produced        Produced          Head        Produced             lb.       Produced        Produced          Head        Produced             lb.       Produced
          Description                #          lbs.           #          $0.00           $000             #             lbs.            #             $0.00           $000             #             lbs.            #             $0.00           $000
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
                                                                     -                $           -                                            -                   $           -                                            -                   $           -
Total Livestock Production                                                            $           -                                                                $           -                                                                $           -




                                                                                          Annual Production Summary and Projection, Page 10 of 15
CASH FLOW BUDGET - GRAIN 200_                                               Name :                                             Signature :                                            Completed as of :         January 0, 1900
                                                      Month                  Jan       Feb       Mar       Apr       May          Jun        Jul       Aug       Sept       Oct       Nov        Dec       Yr. End Totals        Jan 200_    Feb 200_ March 200_
                                               Number of Days in Month       31        28        31        30        31            30        31        31         30        31         30         31                                31          28        31
1 Beginning cash balance                                                                     0         0         0         0            0          0         0          0         0         0          0               0    1            0           0         0
  Operating Receipts
2 Crops and LDP                                                                                                                                                                                                        0    2
3 Government Payments - AMTA, & Oil Seed                                                                                                                                                                               0    3
4 Accounts Receivable                                                                                                                                                                                                  0    4
5                                                                                                                                                                                                                      0    5
6 Capital Receipts:              Machinery & equipment                                                                                                                                                                 0    6
7                                           Real Estate                                                                                                                                                                0    7
8 Non-Farm Income:               Off-farm wages                                                                                                                                                                        0    8
9                                                                                                                                                                                                                      0    9
10 Total Cash Available (add lines 1 - 9)                                          0         0         0         0         0            0          0         0          0         0         0          0               0    10           0           0         0
     Operating Expenses:
11   Grain Storage                                                                                                                                                                                                     0    11
12   Fertilizer, Chemicals and Lime                                                                                                                                                                                    0    12
13   Gas, fuel, oil & Propane for drying                                                                                                                                                                               0    13
14   Insurance (property, liability, crop)                                                                                                                                                                             0    14
15   Marketing and Transportation Expense                                                                                                                                                                              0    15
16   Rents and leases - Land                                                                                                                                                                                           0    16
17   Rents and leases - Machines                                                                                                                                                                                       0    17
18   Repairs - Equipment and Machines                                                                                                                                                                                  0    18
19   Seed                                                                                                                                                                                                              0    19
20   Storage and Custom Drying                                                                                                                                                                                         0    20
21   Supplies                                                                                                                                                                                                          0    21
22   Taxes ( real estate & personal property)                                                                                                                                                                          0    22
23   Utilities (farm share)                                                                                                                                                                                            0    23
24   Farm Management                                                                                                                                                                                                   0    24
25 Total Cash Operating Expenses (add lines 11 - 24)                               0         0         0         0         0            0          0         0          0         0         0          0               0    25           0           0         0
26 Capital Expenditures:        Machinery & Equipment                                                                                                                                                                  0    26           0           0         0
27                      Buildings, Land & Improvements                                                                                                                                                                 0    27           0           0         0
   Other Expenditures:                                                                                                                                                                                                                   0           0         0
28 Family Living withdrawals                                                                                                                                                                                           0    28           0           0         0
29 Income tax and social security                                                                                                                                                                                      0    29           0           0         0
30 Mortgage                                                                                                                                                                                                            0    30           0           0         0
31                                                                                                                                                                                                                     0    31
32   Term debt loan payments            - Principal                                                                                                                                                                    0    32           0           0         0
33                                      - Interest                                                                                                                                                                     0    33           0           0         0
34   Total Cash Required            (add lines 28 - 33)                            0         0         0         0         0            0          0         0          0         0         0          0               0    34           0           0         0
35 Cash Available Less Cash Required (line 10 minus 34)                            0         0         0         0         0            0          0         0          0         0         0          0               0    35           0           0         0
36 Inflows from interest earning accounts                                                                                                                                                                              0    36
37 Cash position before borrowing                                                  0         0         0         0         0            0          0         0          0         0         0          0               0    37           0           0         0
38   Money to be borrowed          - Operating Line                                0         0         0         0         0            0          0         0          0         0         0          0               0    38           0           0         0
                                   - Term Debt                                                                                                                                                                         0
39   Operating loan payments       - Principal                                                                                                                                                                         0    39
40                                 - Interest                                                                                                                                                                          0    40
41   Outflows to interest earning accounts                                                                                                                                                                             0    41
42   Ending cash balance                                                                     0         0         0         0            0          0         0          0         0         0          0               0    42           0           0         0
     Operating Line Balance:                 Balance at Previous Year End
43   Loan Balance                                                                  0         0         0         0         0            0          0         0          0         0         0          0               0    43           0           0         0
            Interest Rate for 1st $200,000              6.54%
44            Interest Rate over $200,000               8.00%                      0         0         0         0         0            0          0         0          0         0         0          0               0    44           0           0         0
                                        0


                  Cash Flow Analysis / Repayment Capacity

                                 200_        200_      200_   Average
 Net Farm Income                                                  0
 Plus: Depreciation                                               0
 Plus: Interest                                                   0
 Plus: Non-Farm Income                                            0
 Minus: Family Living Needs                                       0
 Minus: Income Taxes Paid                                         0

 Total Debt Repayment Capacity    $0          $0        $0       0

 Proposed Debt Service                                           0

 Coverage Ratio               #####         #####    #####    #####



 Income Acres:     124

         Projected Cash Flow: 200_
  Gross Farm Receipts
  Less Operating Expenses
  Net Farm Income               0
  Plus: Non-Farm Income
  Minus: Family Living Needs
Minus: Income Taxes Paid

 Cash Available                   $0

 Proposed Debt Service

 Coverage Ratio               #####




 FILENAME:
         Debtor's Name and Address                            Secured Party's Name and Address

          0                                                                                               Date :      November 14, 2010
          0                                                        Old National Bank
          0                                                          1 Main Street
  Debtor's Soc. Sec. Or Taxpayer I.D. Number                      Evansville, IN 47705
          0

Debtor agrees to provide to Old National Bank a written list of the buyers, commission merchants and selling agents to or through whom the
Debtor may sell the farm products described in the Security Agreement given to Old National Bank and executed by Debtor on the "Security
Agreement Date" specified above. As used in this document, the terms "farm products," "buyers," "commission merchants, " and "selling
agents" have the meanings given to them by the Federal Food Security Act of 1985.

Debtor is providing to Old National Bank the following list of potential buyers, selling agents and commission merchants to or through whom
Debtor anticipates selling the farm products described in the Security Agreement executed by Debtor on the "Security Agreement Date"
specified above. Debtor is aware that sale of the farm product collateral to or through anyone not on this list is illegal unless the Debtor notifies
Old National Bank in writing of the identity of the buyer, selling agent, or commission merchant at least 7 days prior to the sale or Debtor
accounts to Old National Bank for the proceeds of the sale not later than 10 days after the sale. The Debtor agrees that Old National Bank may
require any check or draft issued as full or partial payment for the sale of farm products to be make payable to both Debtor and Old National
Bank. The Debtor agrees to keep this list current and to promptly notify Old National Bank of any changes to this list.

          Debtor and Old National Bank intend that the above terms and the following list amend and become a part of the Security Agreement
          described above.
          Name                                            Address                                                  Farm Products

    1



    2



    3



    4



    5



                If checked, this list replaces any prior list provided by Debtor to Old National Bank. Debtor agrees not to sell any farm products covered by
                the described Security Agreement to anyone named on any prior list unless that same person or entity is also listed above.



          Secured Party:                                                         Debtor's Signature: Debtor acknowledges receipt of a copy of this
                                                                                 document on the date shown above.

          By:                                                                        X
                                                                                     X
          LISTING OF POTENTIAL BUYERS, SELLING AGENTS OR
          COMMISSION MERCHANTS.                                                      X
                                            NOTICE OF SECURITY INTEREST
To:   0                                                                                  Date :              November 14, 2010
      0
      0
Re:   0                                            0                                                         Old National Bank
                    Name of Debtor                  Soc. Sec. Or Taxpayer I.D. #                               1 Main Street
      0                                            0                                                        Evansville, IN 47705
                    Name of Debtor                  Soc. Sec. Or Taxpayer I.D. #
      0                                                                                                Name and Address of Secured Party
      0
                        Address
The Debtor has named you as a potential buyer, commission merchant or selling agent of farm products. You are hereby given notice
pursuant to the Food Security Act of 19985 that the Debtor has given a security interest to Old National Bank in (1) the farm products
described below and (2) any proceeds from the sale of such farm products. This notice is effective for 1 year from the date you receive it.

AGRICULTURAL COMMODITIES:
      Description                                                  Crop Year(s)                   Amount
      All Grain                                                       #REF!                       Unlimited



LIVESTOCK:
      Description                                                                                 Amount




PRODUCTS OF CROPS OR LIVESTOCK:
      Description                                                  Crop Year(s)                   Amount



  If no amount is specified for the above described farm products, the security interest covers all such farm products without limitation as
  to amount. The farm products described above are or may be located on (describe property and county or parish where farm products are
  or may be located):


  X The security interest also covers the described farm products wherever located and is not limited to those located on the above property.
                                                          PAYMENT OBLIGATIONS
  You will be subject to the security interest of Old National Bank in the farm products unless the following payment obligations are satisfied:

  X Any check or draft issued to borrower as full or partial payment for any sale of such farm products must be made payable to both the
    Debtor and Old National Bank, delivered to or received by Old National Bank, and finally paid.

  X If property other than checks or drafts is given as full or partial payment for the sale of such farm products, you must deliver a written
    notice describing the property in detail to Old National Bank at the address stated above within three days after such sale.



  Satisfaction of the payment obligations will not affect the security interest of the Secured Party in proceeds of the sale of such farm products.


                                                                                           (Signature of Authorized Representative of Secured Party)
                                              AGRICULTURAL FINANCIAL STATEMENT
                                                  As of                    January 0, 1900
     Applicant:          0                                                  Co-Applicant:                      0

                                       ASSETS                                                   Market Value
     Current Assets
 1         Cash on Hand and in Banks                                                                           0   Schedule 1
 2         Marketable Securities                                                                               0   Schedule 2
 3         Government Payments Receivable                                                                      0   Schedule 6
 4         Unrealized Gains (Losses) on Futures and Options                                                    0   Schedule 5
 5         Livestock Held For Sale                                                                             0   Schedule 8
 6         Grain and Forage Held For Sale                                                                      0   Schedule 10
 7         Grain and Forage Held as Feed                                                                       0   Schedule 11
 8         Investment in Growing Crops                                                                         0   Schedule 12
 9         Prepaid Expenses and Supplies on Hand                                                               0   Schedule 13
10         Other Receivables                                                                                   0   Schedule 7
11         Cash Surrender Value Life Insurance                                                                 0   Schedule 4
12         Other Current Assets                                                                                0   Schedule 14

                  Total Current Assets                                                                         0
     Non-Current Assets
13        Breeding and Production Livestock                                                                    0   Schedule 9
14        Machinery, Equipment, and Vehicles Held Under Capital Leases                                         0   Schedule 15
15        Machinery, Equipment, and Vehicles Owned                                                             0   Schedule 16
16        Farm Real Estate Owned - Undivided Interest                                                          0   Schedule 18
17        Farm Real Estate Owned - Partial Interest                                                            0   Schedule 19
18        Non-Farm Real Estate Owned                                                                           0   Schedule 21
19        Retirement Accounts ( IRA, Pension, 401K, etc.)                                                      0   Schedule 3
20        Personal and Other Non-Current Assets                                                                0   Schedule 22

                  Total Non-Current Assets                                                                     0

     TOTAL ASSETS                                                                                              0


                             LIABILITIES AND NET WORTH
     Current Liabilities
21         Machinery & Equipment held under Operating Lease                                                    0   Schedule 17
22         Accounts Payable                                                                                    0   Schedule 23
23         Operating Lines and Other One Year Notes                                                            0   Schedule 24
24         Other Current Liabilities                                                                           0   Schedule 25
25         Credit Card Debt Due Within 12 Months                                                               0   Schedule 26
26         Current Portion of Long Term Loans and Leases                                                       0   Schedule 27
27         Current Portion of Other Long Term Liabilities                                                      0   Schedule 28
                  Total Current Liabilities                                                                    0
   Non-Current Liabilities
28      Portion of Credit Card Debt Principal Balance Due Beyond 12 Months                                     0   Schedule 26
29      Portion of Long Term Loans and Capital Leases Due Beyond 12 Months                                     0   Schedule 27
30      Portion of Other Long Term Liabilities Due Beyond 12 Months                                            0   Schedule 28

                  Total Non-Current Liabilities                                                                0

     TOTAL LIABILITIES                                                                                         0

     NET WORTH                                                                                                 0

     TOTAL LIABILITIES & NET WORTH                                                                             0



                                                   Agricultural Financial Statement, Page 15 of 15

								
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