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					                               Financial Statement Update Request
In order to ensure D&B has your most current financial information on file, you may either submit
an electronic copy of your *current financial statement, including balance sheet and profit and loss
statement, or utilize this form to submit your information. Please email your submittal to
statementreview@dnb.com. Be sure to include your company name, address, contact information,
and DUNS# if known in your email. Please see additional requirements at end of this document.

*Note that a year end FISCAL STATEMENT IS PREFERRED.
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Company Name :
Address:
City:
St:
Zip:
DUNS # (if known):

BALANCE SHEET
Please include figures to the exact dollar (cents are not required). Blank spaces are provided for statement
items that do not fall into specified categories. Use the TAB KEY to move between fields.

STATEMENT OF FINANCIAL CONDITION:
Date of Statement: is this a fiscal or an interim               statement?

                         ASSETS                                              LIAB ILITIES
Cash                                                     Accounts Payable
Accounts Receivable                                      Bank Loans
Inventory                                                Note Payable
Notes receivable
Marketable Securit ies                                   Accruals
                                                         Taxes
                                                         Loans & Advance-Principals
                                                         Long Term Liab-Other
Other Current Assets                                     Other Current Liabilit ies
CURRENT ASS ETS                                          CURRENT LIAB ILITIES

Fixtures/Equip ment
Mortgages
                                                         Long Term Liab-Other
                                                         Def. Credits/Income
Real Estate                                              CAPITAL STOCK
CVS of life Ins.                                         PREFERRED STOCK
Investment-Other                                         COMMON STOCK
Deposits                                                 ADDITIONA L PAID IN CAP

                                                         RETAINED EA RNINGS
                                                         NET WORTH
Other Assets
TOTAL ASSETS                                             TOTAL LIAB. / CAP.

   Prepared fro m Statement(s) by Accountant
   Prepared fro m Books without Audit
   Audited Statement (Please include copy of Accountant’s Opinion)
   Reviewed by:         Title        Date
PROFIT AND LOSS

For Period:
Fro m:
To:

Sales
Cost of Goods Sold

Gross Profit
Operating Expense

Operating Inco me (Loss)
Other Inco me
Other Expenses
Net Inco me Before Taxes
Income Tax
Other Tax




Net Inco me
Net Loss


Minimum Require ments Financial Information

You have the option of having your financial information presented in D&B’s Minimum
Requirement format as stated below.

D&B requires a copy of your full balance sheet, in order to process your financial information in the
Minimum Requirement format. D&B cannot rate or score a company on its financia l position without its
financial statement data, whether it is full disclosure or minimum requirement format.

D&B will indicate in your business report that one of our analysts reviewed your company’s full balance
sheet. The balance sheet will also be used to determine ratios that will be used in determining your
ratings and Financial Stress Scores.

Using the full balance sheet you submit in its entirety, only total figures will be shown in your report.
Total figures include: Total Current Assets, Other Assets, Total Current Liabilities, Other Liabilities,
Worth/Equity, Sales and Net Income. There will not be a breakdown of figures for each item. However,
there will be an explanation of what accounts make up the totals. For example, Total Current Assets
consist of cash, accounts receivable, inventory and prepaids. Other businesses inquiring on the report will
not be able to see the full balance sheet, as it will not be published in its entirety.

Please forward your company’s financial statement directly to statementreview@dnb.com.
Please indicate Minimum Requirements on the statement so that the presentation of your financial
information will be as Minimum Requirements.


Thank you
D&B Financial State ment Team

				
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Description: Financial Information document sample