Utah Department of Environmental Quality Division of Environmental Response and Remediation Petroleum Storage Tank Loan Program Balance Sheet Statement for: as of: Assets Liabilities $ $ 1. Cash on hand and in banks Accounts Payable (Schedule 7d) 2. Accounts and Notes receivable (Schedule 1) Notes Payable- Secured (Schedule 7b) 3. Inventory (Schedule 2) Notes Payable- Unsecured (Schedule 7c) 4. Other Current Assets: Taxes 5. Other Current Debts: 6. 7. 8. Life Insurance, Cash Surrender Value 9. Stocks and Bonds (Schedule 3) $ 10. Total Current Assets: Judgments $ $ 11. Equipment (Schedule 4) Total Current Liabilities: $ 12. Vehicles (Schedule 5) Real Estate Mortgages Payable (Schedule 7a) 13. Real Estate (Schedule 6) Equipment (Schedule 7b) 14. Long-term Portion of Notes Receivable Vehicles (Schedule 7b) 15. Other Assets: Long-term Notes Payable (Schedule 7e) 16. Other Liabilities: 17. $ 18. Total Long-term Liabilities: $ 19. Total All Liabilities: $ 20. Total Long-term Assets: $ 21. Total Net Worth (If a corporation, complete Schedule 10.): $ $ 22. Total Assets: Total Liabilities and Net Worth: Supplemental Schedules. If additional space is needed, attach sheet(s) No. 1 Accounts and Notes Receivable Name and address of Debtor Payment Date Date of Debt Description of Security Held Amt. Owed Total Value: $ No. 2 Inventory Description Value Description Value Total Value: $ No. 3 Stocks and Bonds Face Value (Bonds) or Income No. Shares Received Present (Stock) Name of Corporation Cost Last Year To Whom Pledged Market Value Total Value: $ No. 4 Equipment
Utah Department of Environmental Quality Division of Environmental Response and Remediation Petroleum Storage Tank Loan Program Balance Sheet Statement for: as of: Assets Liabilities 1. Cash on hand and in banks $ Accounts Payable (Schedule 7d) $ 2. Accounts and Notes receivable (Schedule 1) Notes Payable- Secured (Schedule 7b) 3. Inventory (Schedule 2) Notes Payable- Unsecured (Schedule 7c) 4. Other Current Assets: Taxes 5. Other Current Debts: 6. 7. 8. Life Insurance, Cash Surrender Value 9. Stocks and Bonds (Schedule 3) 10. Total Current Assets: $ Judgments 11. Equipment (Schedule 4) $ Total Current Liabilities: $ 12. Vehicles (Schedule 5) Real Estate Mortgages Payable (Schedule 7a) $ 13. Real Estate (Schedule 6) Equipment (Schedule 7b) 14. Long-term Portion of Notes Receivable Vehicles (Schedule 7b) 15. Other Assets: Long-term Notes Payable (Schedule 7e) 16. Other Liabilities: 17. 18. Total Long-term Liabilities: $ 19. Total All Liabilities: $ 20. Total Long-term Assets: $ 21. Total Net Worth (If a corporation, complete Schedule 10.): $ 22. Total Assets: $ Total Liabilities and Net Worth: $ Supplemental Schedules. If additional space is needed, attach sheet(s) No. 1 Accounts and Notes Receivable Name and address of Debtor Payment Date Date of Debt Description of Security Held Amt. Owed Total Value: $ No. 2 Inventory Description Value Description Value Total Value: $ No. 3 Stocks and Bonds Face Value (Bonds) or No. Shares (Stock) Name of Corporation Cost Income Received Last Year To Whom Pledged Present Market Value Total Value: $ No. 4 Equipment