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					Instructions
A.   Save this to your PC by going to File…Save As. This must be saved as Excel 97 or 7.0 in order to work properly.
B.   Attached are 8 worksheets that pre-fill into the last sheet entitled "Financial Statement - Output".
             1. Personal Information
             2. Income & Expenses
             3. Schedule 1 - Bank Accounts
             4. Schedule 2 - Investments (Life Insurance, Retirement, Marketable and Unmarketable securities, etc.)
             5. Schedule 3 - Notes Payable (Non-Real Estate)
             6. Schedule 4 - Real Estate
             7. Assets & Liabilities (several of these fields pre-fill from previous worksheets)
             8. Questions

C.   Complete,where applicable, the yellow highlighted cells. Cells with a red mark in the upper right hand corner have a "comment" or
     "definition" when your mouse pointer passes over the cell.
D.   Once you have completed all worksheets, set to print on 2 pages and review the Financial Statement-Output.
E.   Read the statement at the bottom then sign and date the form.
F.   If you are completing this as part of a loan requirement, please mail or hand deliver the statement to your banking officer.
     For security reasons, Do not e-mail the completed financial statement.
G.   Contact your banking officer if you have any questions about this form.
        PERSONAL PROFILE
        Name:
        Residential Address:
        City / State / Zip:                                                       Time at Present Address:                 (# Years / # Months)
        Social Security Number:                                                   Date of Birth:                           (MM/DD/YY)

                                                                                  Housing Info:
        Home Phone:                                                                                            (Own, Rent, Other)
        Marital Status*                                                           No. of Dependents
        Employed By:                                                              Years:                       Position:                             Bus Phone:
        Previous Employment:                                                      Years:                       Position:                             Bus Phone:


        SPOUSE'S PROFILE**
        Name:                                                                     Date of Birth:                           Social Security Number:
        Employed By:                                                               Years:                      Position:                              Bus Phone:
        * Married, Unmarried, Separated
        ** Do not complete the starred (*) sections of this form unless you (a) are a resident of a community property state, (b) are relying on property located
        in a community property state as a basis for repayment of the credit requested, or (c) are applying jointly with your spouse for the credit requested.




dbcd5843-d08a-4dcb-b211-91415778ff87.xls                                         Personal Information                                                               4/21/2011
              ANNUAL INCOME (1)                     AMOUNT        (1) You must check the box on the OUTPUT sheet at line 44 if you are providing a current year
              Salary & Wages                                  0   income tax return complete with all schedules in lieu of completing the above section, "Annual
              Spouse's Income*                                0   Income". By doing so, you certify that the tax return information is correct and that Red River Bank
                                                                  may rely upon it as stated below. Note: The Annual Expenditures and Contingent Liabilities sections
              Commission, Bonus                               0
                                                                  must still be completed.
              Interest, Dividends                             0
              Gross Rental Income                             0
              Payments from Notes Receivable                  0   (2) Alimony, child support, or separate maintenance income need not be revealed if you do not wish
              Alimony/Child Support (2)                       0   to have it considered as a basis for repaying this obligation.
              Other recurring Income                          0
              Nonrecurring Income
              TOTAL                                           0


              ANNUAL EXPENDITURES                   AMOUNT                      CONTINGENT LIABILITIES AMOUNT
              Mortgage payments (or Rent)                     0                 As Endorser                   0
              Other Real Estate Mortgages                     0                 As Guarantor                  0
              Automobile Payments                             0                 On Damage Claims              0
              Other Installment Payments                      0                 Letter of Credit              0
              Alimony/Child Support                           0                 Other:                        0
              Credit Card Payments                            0                 TOTAL                         0
               Other *       taxes                             0
               Other*
               Other*
              TOTAL                                            0
              * Place "other" expenditure description under column B in the space provided.




dbcd5843-d08a-4dcb-b211-91415778ff87.xls                                      Income & Expenses                                                                          4/21/2011
                SCHEDULE 1 - (IF YOU USE MORE THAN 6 LINES, PLEASE PRINT THIS PAGE FOR YOUR BANKING OFFICER, AS ONLY 6
                LINES WILL TRANSFER TO THE FINAL STATEMENT. THOUGH, ALL WILL BE INCLUDED IN THE DOLLAR TOTALS.).



                BANKING RELATIONSHIP (Please list only your personal accounts).
                             BANK**                  ACCOUNT NUMBER               TYPE OF ACCOUNT   BALANCE        IS IT PLEDGED?




                                                                                                               0




dbcd5843-d08a-4dcb-b211-91415778ff87.xls                  SCHEDULE 1 - Bank Accounts                                                4/21/2011
   SCHEDULE 2 - (NOT ALL LINES OF DATA WILL TRANSFER TO THE FINAL OUTPUT. THOUGH, ALL WILL BE INCLUDED IN THE DOLLAR TOTALS. IF THIS IS
   YOUR CASE, THEN PLEASE PRINT AND ATTACH THIS SHEET TO THE FINANCIAL STATEMENT.)



   STOCKS AND BONDS (INCLUDING MUTUAL FUNDS)
   Note: This is for Liquid investments only, not for Closely Held Companies, IRA,Retirement Funds, Annuities or Life Insurance.
                                                                                        NO. OF MKT VALUE TOTAL MARKET GOV.SECURITY? PLEDEGED? RESTRICTED
          ISSUER            REGISTERED IN NAME OF              WHERE TRADED
                                                                                       SHARES PER SHARE     VALUE       YES OR NO   YES OR NO ? YES OR NO




   RETIREMENT ACCOUNTS & ANNUITIES (IRA'S , KEOGH'S, PENSIONS)
                                                                                        NO. OF MKT VALUE TOTAL MARKET              PLEDEGED?   RESTRICTED
          ISSUER            REGISTERED IN NAME OF              WHERE TRADED
                                                                                       SHARES PER SHARE     VALUE                  YES OR NO   ? YES OR NO




   CLOSELY HELD COMPANIES (not listed on major stock exchange)
           NAME                                                   OWNED BY                         # SHARES         % OWNED         TOTAL MARKET VALUE




dbcd5843-d08a-4dcb-b211-91415778ff87.xls                                    SCHEDULE 2-Investments                                                           4/21/2011
   LIFE INSURANCE
                                                                TYPE OF POLICY                                   $ LOANS
         ISSUER          PERSON INSURED    OWNER OF POLICY                             FACE VALUE   CASH VALUE
                                                             (term, whole,universal)                             PLEDGED




dbcd5843-d08a-4dcb-b211-91415778ff87.xls             SCHEDULE 2-Investments                                                4/21/2011
       SCHEDULE 3 - (NOT ALL LINES OF DATA WILL TRANSFER TO THE FINAL OUTPUT. THOUGH, ALL WILL BE
       INCLUDED IN THE DOLLAR TOTALS. IF THIS IS YOUR CASE, THEN PLEASE PRINT AND ATTACH THIS SHEET TO THE
       FINANCIAL STATEMENT.)




       NOTES PAYABLE (EXCLUDING REAL ESTATE MORTGAGES)
                                                                                                                                                        COLLATERAL
                                                         (If Line of Credit)                       PAYMENT         PAYMENT
                 DUE TO              BALANCE DUE                               ACCOUNT NO.                                          MATURITY          (Automobile, Other-   RATE
                                                          CREDIT LIMIT                             AMOUNT           FREQ.
                                                                                                                                                     Secured, Unsecured)




                                      $             -
       Note1: This does not include any debt that you guarantee for your companies.
       Note2: The collateral type must be one of the three exactly. I.e. if "vehicle" is used instead of "automobile" it will not subtotal on the final output sheet.

       NOTES RECEIVABLE (EXCLUDING REAL ESTATE MORTGAGES)
                                                         (If Line of Credit)      PAYMENT          PAYMENT
               DUE FROM              BALANCE DUE                                                                   MATURITY
                                                          CREDIT LIMIT            AMOUNT            FREQ.




dbcd5843-d08a-4dcb-b211-91415778ff87.xls                                       SCHEDULE 3-Notes Payable                                                                            4/21/2011
                            $        -




dbcd5843-d08a-4dcb-b211-91415778ff87.xls   SCHEDULE 3-Notes Payable   4/21/2011
   SCHEDULE 4 - (PROVIDE SEPARATE SHEET IF NECESSARY).

   REAL ESTATE HOLDINGS
   Property Type Includes: Personal Residence, Other Residential, Commercial/Industrial, Partially Owned residential, Partially Owned Commercial
       REQUIRED INFORMATION                  FIRST PROPERTY               SECOND PROPERTY             THIRD PROPERTY               FOURTH PROPERTY       FIFTH PROPERTY

   Property Type (see above)
   Property Address
   Cost & Improvements                  $                         -   $                       -   $                        -   $                     -
   Estimated Market Value                $                        -   $                       -   $                        -   $                     -
   Mortgage balance                      $                        -   $                       -   $                        -   $                     -
   Mortgage Lender/Yr. Purchased
   Monthly Principal and Int. Pmts      $                         -   $                       -   $                        -   $                     -
   Interest Rate/Maturity
   Annual Gross Rental Income            $                        -   $                       -   $                        -   $                     -
   Annual Cash Operating Expense         $                        -   $                       -   $                        -   $                     -
   Percent of Ownership*                          0.00%                        0.00%                       0.00%                        0.00%                0.00%




                                                                                                                                                                     4/21/2011
dbcd5843-d08a-4dcb-b211-91415778ff87.xls                                    SCHEDULE 4 - Real Estate
          Note: Some items are prefilled totals from Schedules 1-4. Please check these totals and correct if needed. Then, please complete the remaining items.


          FINANCIAL STATEMENT **- List in dollars only. Please attach a separate sheet if further space is needed.
                                                  ASSETS                                                                           LIABILITIES
          Cash held at Red River Bank (Schedule 1)                            0                      Due on Automobiles (Schedule 3)                           0
          Cash held at Other Institutions (Schedule 1)                        0                      Notes Payable - Secured (Schedule 3)                      0
          U.S. Government Securities (Schedule 2)                             0                      Notes Payable - Unsecured (Schedule 3)                    0
          Marketable Listed Securities (Schedule 2)                           0
          Closely Held Companies (Schedule 2)                                 0                      MORTGAGES PAYABLE: (Schedule 4)
          Notes & Accounts Receivable                                         0                         Due on Personal Residence                              0
          Cash Value of Life Insurance                                        0                         Due on Other Owned Real Estate                         0
          IRA / Keogh's / Pensions                                            0                      Oil and Gas Liablilties
          REAL ESTATE (Schedule 4)                                                                   Revolving Charge Obligations                              0
             Personal Residence                                               0                      Unpaid Income Taxes                                       0
             Other Owned Real Estate                                          0                      Loans on Life Insurance                                   0
          Oil and Gas Interests                                                                      Other Liabilities
          Automobiles                                                                                Other Liabilities
          Business Equity (other than listed above)                                                  TOTAL LIABILITIES (L)                                     0
          Other Assets                                                                               NET WORTH (NW) = (A-L)                                    0
          TOTAL ASSETS (A)                                                    0                      TOTAL (L + NW)                                            0

          ** You must check the box on the OUTPUT sheet at line 44 if you are providing a current year income tax return complete with all schedules in lieu of
          completing the above section, "Annual Income". By doing so, you certify that the tax return information is correct and that Red River Bank may rely upon it as
          stated below. Note: The Annual Expenditures and Contingent Liabilities sections must still be completed.




dbcd5843-d08a-4dcb-b211-91415778ff87.xls                                          Assets & Liabilities                                                                     4/21/2011
            GENERAL INFORMATION* (If married, these questions apply to both you and your spouse).   Yes or No
            Have you ever had assets repossessed by a creditor?
            Have you ever filed bankruptcy or had a judgement against you?
            Have you ever been a principal of a firm that declared bankruptcy?
            Are you party to any claim or lawsuit?
            Are any assets pledged or debts secured except as shown?
            What is your total life insurance coverage?
            Are any assets held in trust, in estate or in any other name or capacity?
            If you answered YES to any of the above, please explain:


            Have you been involved in an IRS Audit in the past 3 years?
            Results of IRS Audit


            Do you have a will/estate plan?
            Do you have a separate property agreement?
            Have you ever been convicted or plead nolo contendere to a Felony?
            What is your disability insurance coverage?




dbcd5843-d08a-4dcb-b211-91415778ff87.xls                                                Questions               4/21/2011
RED RIVER BANK                                                                      Personal Financial Statement
Notice: This statement is designed for use by residents of community property states (Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, or Wisconsin).
This statement should reflect the borrower's financial condition. List all of your separate assets and any community property or income in which you have an interest, as
well as all debts which may be satisfied out of either your separate or community property. If you are seeking credit jointly with your spouse, then include all community
property and separate property on the Personal Financial Statement form. Do not complete the starred (*) sections of this form unless you (a) are a resident of a
community property state, (b) are relying on property located in a community property state as a basis for repayment of the credit requested, or (c) are applying jointly with
your spouse for the credit requested.

Financial Statement Date:
PERSONAL PROFILE
Name:                                                                                        Date of Birth:                                Social Security Number:
Residence Address:                                                                          City/State/Zip:
Marital Status*                                                                    No. of Dependents:
Home Phone                                                      Housing Info:                       Time at Present Address:                            (# Years / # Months )
Employed By:                                                    Years:                              Position:                              Bus.Phone:
Previous Employment:                                            Years:                              Position:                              Bus.Phone:
SPOUSE'S PROFILE* (see notice above)
Name:                                                                              Date of Birth:                                          Social Security Number: 000-00-0000
Employed By:                                                    Years:                              Position:                              Bus.Phone:
FINANCIAL STATEMENT - List in dollars only. Please attach a separate sheet if further space is needed.
                                          ASSETS                                                                                           LIABILITIES
Cash held at Red River Bank (Schedule 1)                                 0                          Due on Automobiles (Schedule 3)                                     0
Cash held at Other Institutions (Schedule 1)                             0                          Notes Payable - Secured (Schedule 3)                                0
U.S. Government Securities (Schedule 2)                                  0                          Notes Payable - Unsecured (Schedule 3)                              0
Marketable Listed Securities (Schedule 2)                                0
Closely Held Companies (unlisted)(Schedule 2)                            0                          MORTGAGES PAYABLE: (Schedule 4)
Notes & Accounts Receivable                                              0                            Due on Personal Residence                                         0
Cash Value of Life Insurance                                             0                            Due on Other Owned Real Estate                                    0
IRA/Keogh's/ Pensions                                                    0                          Oil and Gas Liablilties                                             0
REAL ESTATE (Schedule 4)                                                                            Revolving Charge Obligations                                        0
  Personal Residence                                                     0                          Unpaid Income Taxes                                                 0
  Other Owned Real Estate                                                0                          Loans on Life Insurance                                             0
Oil and Gas Interests                                                    0                          Other Liabilities                                                   0
Automobiles                                                              0                          Other Liabilities                                                   0
Business Equity (other than listed above)                                0                          TOTAL LIABILITIES (L)                                               0
Other Assets                                                             0                          NET WORTH (NW) = (A-L)                                              0
TOTAL ASSETS (A)                                                         0                          TOTAL (L + NW)                                                      0
      ANNUAL INCOME (1)                  AMOUNT             ANNUAL EXPENDITURES                         AMOUNT                   CONTINGENT LIABILITIES               AMOUNT
Salary & Wages                                     0   Mortgage payments (or Rent)                                      0   As Endorser                                          0
Spouse's Income*                                   0   Other Real Estate Mortgages                                      0   As Guarantor                                         0
Commission, Bonus                                  0   Automobile Payments                                              0   On Damage Claims                                     0
Interest, Dividends                                0   Other Installment Payments                                       0   Letter of Credit                                     0
Gross Rental Income                                0   Alimony/Child Support                                            0   Other                   0                            0
Payments from Notes Receivable                     0   Credit Card Payments                                             0                                                        -
Alimony/Child Support (2)                          0   Other    taxes                                                   0                                                        -
Other recurring Income                             0   Other                   0                                        0                                                        -
Nonrecurring Income                                0   Other                   0                                        0                                                        -
TOTAL                                               0 TOTAL                                                      0 TOTAL                                                   0
                         (1) Check here if you are providing a current year income tax return complete with all schedules in lieu of completing the above section, "Annual
                         Income". By doing so, you certify that the tax return information is correct and that Red River Bank may rely upon it as stated below. Note: The
                         Annual Expenditures and Contingent Liabilities sections must still be completed.

(2) Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

GENERAL INFORMATION* (If married, these questions apply to both you and your spouse).
Have you ever had assets repossessed by a creditor?                                                 Have you been involved in IRS Audit in the past 3 yrs?
Have you ever filed bankruptcy or had a judgement against you?                                      Results of IRS Audit
Have you ever been a principal of a firm that declared bankruptcy?
Are you party to any claim or lawsuit?
Are any assets pledged or debts secured except as shown?                                            Do you have a will/estate plan?
What is your total life insurance coverage?                                                         Do you have a separate property agreement?
Are any assets held in trust, in estate or in any other name or capacity?                           Have you ever been convicted or plead nolo contendere
If you answered YES to any of the above, please explain:                                            to a Felony?
                                                                                                    What is your disability insurance coverage?
For Bank Use Only:                                                                                                          Reviewed By:
Date Received: ___/___/___          Direct Account NO.:                                                                     Indirect Account No,:
SCHEDULE 1 - BANKING RELATIONSHIP (Please provide input sheet if not all records transferred due to space restrictions.)
                         BANK                                     ACCOUNT NUMBER                       TYPE OF ACCOUNT                          BALANCE                   IS IT PLEDGED?



0                                                       0                                         0                                     0                             0
0                                                       0                                         0                                     0                             0
0                                                       0                                         0                                     0                             0
0                                                       0                                         0                                     0                             0
SCHEDULE 2 - INVESTMENTS (Please provide input sheet if not all records transferred due to space restrictions.)
STOCKS AND BONDS (INCLUDING MUTUAL FUNDS)
Note: This is for Liquid investments only, not for Closely Held Companies, IRA,Retirement Funds, Annuities or Life Insurance.
                           REGISTERED IN NAME                                   NO. OF       MKT VALUE             TOTAL MARKET       PLEDEGED? RESTRICTED?
       ISSUER                                             WHERE TRADED
                                     OF                                         SHARES       PER SHARE                  VALUE         YES OR NO   YES OR NO
                                                       0                                                                      #VALUE!           0
                                                        0                                                                               #VALUE!                       0
0                        0                              0                                    0                  $0.00                         $0.00               0 0
0                        0                              0                                    0                  $0.00                         $0.00               0 0
0                        0                              0                                    0                  $0.00                         $0.00               0 0
0                        0                              0                                    0                  $0.00                         $0.00               0 0
RETIREMENT ACCOUNTS & ANNUITIES (IRA'S , KEOGH'S, PENSIONS)
                REGISTERED IN NAME                          NO. OF                                    MKT VALUE              TOTAL MARKET             PLEDEGED?           RESTRICTED?
     ISSUER                               WHERE TRADED
                        OF                                  SHARES                                    PER SHARE                 VALUE                 YES OR NO            YES OR NO
                                      0
                                                        0
0                        0                              0                            $        -   $              -       $                       -          0                   0
CLOSELY HELD COMPANIES
                                                                                     NO. OF
        NAME                                          OWNED BY                                                                   TOTAL MARKET VALUE
                                                                                     SHARES           % OWNED



0                                                           0                        $        -         0.00%            $                                        -
LIFE INSURANCE
                                                                                     TYPE OF POLICY         (term,                                        CASH              $ LOANS
       ISSUER                PERSON INSURED                 OWNER OF POLICY                                                   FACE VALUE
                                                                                              whole)                                                      VALUE             PLEDGED



                                                                                                                                                                      $                 -
SCHEDULE 3 - NOTES PAYABLE (EXCLUDING REAL ESTATE MORTGAGES)
                                                                                     PAYMENT
             DUE TO                     BALANCE                 ACCOUNT NO.                  PAYMENT FREQ. MATURITY                           COLLATERAL                      RATE
                                                                                     AMOUNT
                                                                                                                         0
                                                        0                                                                0
0                                   $                 - 0                            $        - 0                        0              0                                     0.00%
0                                   $                 - 0                            $        - 0                        0              0                                     0.00%
0                                   $                 - 0                            $        - 0                        0              0                                     0.00%
0                                   $                 - 0                            $        - 0                        0              0                                     0.00%
SCHEDULE 4 - REAL ESTATE HOLDINGS - PROVIDE SEPARATE SHEET IF NECESSARY.
Property Type Includes: Personal Residence, Other Residential, Commercial/Industrial, Partially Owned residential, Partially Owned Commercial
    REQUIRED INFORMATION                FIRST PROPERTY                    SECOND PROPERTY               THIRD PROPERTY                      FOURTH PROPERTY           FIFTH PROPERTY
Property Type (see above)                                                                                                                                             0
Property Address                                                                                                                                                      0
Cost & Improvements                 $                             -   $                       -   $                                 -   $                         -   $                 -
Estimated Market Value              $                             -   $                       -   $                                 -   $                         -   $                 -
Mortgage balance                    $                             -   $                       -   $                                 -   $                         -   $                 -
Mortgage Lender/Yr. Purchased      0                                  0                           0                                     0                             0
Monthly Principal and Int. Pmts     $                             -   $                       -   $                                 -   $                         -   $                 -
Interest Rate/Maturity                            0                              0                                   0                                0                         0
Annual Gross Rental Income          $                             -   $                       -   $                                 -   $                         -   $                 -
Annual Cash Operating Expense       $                             -   $                       -   $                                 -   $                         -   $                 -
Percent of Ownership                            0.00%                          0.00%                            0.00%                             0.00%                       0.00%
For the purpose of obtaining and/or maintaining credit, I submit this financial statement as a true, complete and accurate statement of my financial condition as of the date
hereof and the date of my signature below. I will notify you immediately in the event of any material change in my financial condition, and until such time, you may continue
to rely upon this statement. This statement shall remain your property.
You are authorized to verify the information herein, and obtain such additional information as you may require, by contacting my spouse and other third parties. You may
exchange with, or furnish information to, others regarding your credit experience with me.
Signature of Preparer if other than Borrower:
Signature of Borrower:                                                                                                   Date:
Signature of Spouse, if spouse is a joint Co-Borrower:                                                                   Date:

				
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