Statement of Affairs (SOA 1) Debtor Debtor ID Date NAMA Held Assets & Liabilities Name of Entity % of Asset Location Asset Bank/ Value Valuation Valuation Debt Debt Net Value Annual Annual Annual Annual Debt Servicing (13) Debt Service Debt Guarantee Guarantor Guarantee € Entity ownership (1) Description Lender (3) (4) basis (5) Date (6) Limit Drawn (9) Income Holding Surplus Agreement (17) Expiry Name(20) Type(21) € € € €(19) (2) (7) Balance (10) Costs Cash Date (18) € € (8) (11) (12) € Interest Capital (14) Repayment Commitment € € € (15) (16) Sub Other Bank/Lender Held Assets & Liabilities Name of Entity % of Asset Location Asset Bank/ Value Valuation Valuation Debt Debt Net Value Annual Annual Debt Servicing Annual Surplus Debt Service Debt Guarantee Guarantor Guarantee € Entity Ownership To include Folio Description Lender Basis Date Limit Drawn Income Holding Cash Agreement Expiry Name Type € € € € € Number or Balance Costs Date € € details of predecessor /previous Owner (If applicable) Interest Capital Total € Repayment Commitment € € Sub Total Unencumbered Assets (22) Properties NAME OF Entity % of Asset Location Asset Description Valuation Valuation Date Annual Income Annual Holding Costs Surplus Income € € € € ENTITY Ownership To include Folio Number or details of predecessor /previous (If applicable) Owner (If applicable) Sub Total Bank Accounts Account Name Account Number Sort Code IBAN Bank Name & Address Account Type Balance Balance Currency € Sub Total Cash (232)
Statement of Affairs (SOA 1) Debtor Debtor ID Date NAMA Held Assets & Liabilities Name of Entity Entity % of ownership Asset Location (1) Asset Description (2) Bank/ Lender (3) Value € (4) Valuation basis (5) Valuation Date (6) Debt Limit € (7) Debt Drawn Balance € (8) Net Value € (9) Annual Income € (10) Annual Holding Costs € (11) Annual Surplus Cash € (12) Annual Debt Servicing (13) Debt Service Agreement (17) Debt Expiry Date (18) Guarantee €(19) Guarantor Name(20) Guarantee Type(21) Interest (14) € Capital Repayment € (15) Commitment € (16) Sub Other Bank/Lender Held Assets & Liabilities Name of Entity Entity % of Ownership Asset Location To include Folio Number or details of predecessor /previous Owner (If applicable) Asset Description Bank/ Lender Value € Valuation Basis Valuation Date Debt Limit € Debt Drawn Balance € Net Value € Annual Income € Annual Debt Servicing Annual Holding Costs € Surplus Cash € Debt Service Agreement Debt Expiry Date Guarantee € Guarantor Name Guarantee Type Interest € Capital Repayment € Total Commitment € Sub Total Unencumbered Assets (22) Properties NAME OF ENTITY Entity % of Ownership Asset Location To include Folio Number or details of predecessor /previous Owner (If applicable) Asset Description € Valuation Valuation Date Annual Income € Annual Holding Costs € (If applicable) Surplus Income € Sub Total Bank Accounts Account Name Account Number Sort Code IBAN Bank Name & Address Account Type Balance € Balance Currency Sub Total Cash (232)
Statement_of_Affairs_Template__ROI__v2_1_.docx