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5.(a)Please list the banks that you are currently dealing with:
(b)Do you have a safety deposit box? Yes No
If so, which bank?
Please provide details of the contents:
6.Does anyone owe you any money? Provide details. Yes No
(c)Agreement for sale
7.Do you currently own any of the following?
(a)Collectibles (stamps, coins, art, antiques, etc.) Yes No
(b)Savings bonds (owned presently or being purchased
on a payroll savings plan).Yes No
(c)Shares (owned presently or being purchased on a
payroll savings plan).Yes No
Please provide details
(d)Personal life insurance policies (please include Yes No
a copy of your life insurance policy).
Policy No. 1
Policy No. 2
i)Life Insurance Company
iii)Cash Surrender Value
8.Are you a beneficiary of a will or will you receive
an inheritance?Yes No
9.Has anyone started legal proceedings against you?Yes No
If yes, give details.