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erln C.e Pederol Reserve bank of Della • • <br />.. <br />PERSONAL FINANCIAL STATEMENT <br />Name James R. Rosier Ta, Bank <br />Address3~15 West Creek Club Dr. <br />Missouri City Tx. 77459 <br />city stet. <br />Telephone (713) x+99-x+755 _ <br />Business ar occapafian President - Process Products, Inc . <br />Partner or Officer in any other venture IVO <br />Are any assets pledged? NO <br />Have you ever made a composition settlement or taken bankruptcy? Explain• NO <br />For the purpose of procuring and maintaining credit from time to time in any form whatsoever with the above-named dank, for claims and demands against the undersigned, the <br />undersigned submits the following as being a true and accurate statement of its financial condition on the following dote, and agrees that if any change occurs that materially reduces <br />the means or ability of the undersigned to pay all claims or demands against it, the undersigned will immediately and without delay notify the said Bank, and unless the Bank <br />is so notified, it may continue to rely pupon the statement herein given as a true and accurate statement of the financial condition of the undersigned as of the close of <br />business 2-13-'J4 19 <br />ASSETS <br />l1ABILITIES AND NET WORTH <br />Cash on Hand and in Banks (Schedule lJ j 000 Notes Payable fo Banks-Secured (Schedule I) ~ S l~ <br />U. S. Government Securities -0- Unsecured (Schedule t) <br />Accounts, loans and Notes Receivable (Schedule 1) -0- Notes Payable to Relatives <br />Cash Surrender Value life Insurance (Schedule 3) ~ 00 Accounts and Notes Payable to Others 00 <br />Other Stocks and Bonds (Schedule 4) -0- Rents and Interest Due <br />Real Estate (Schedule S) 112500 Taxes Due (Schedule 5) <br />Automobiles-Number (1 ) 5000 liens on Real Estate (Schedule S) x0000 <br />Other Assets (Itemize) Other liabilities (Itemize) <br />Household Golf Cart 15000 ~ ~ <br />I R.~ 22 G _ <br />- C-2 Beechraft Air lane 12000 <br />Retirement Plan ~ Control 000 <br />S ecialties Inc. i <br /> <br />TOTAL LIABILITIES pp <br />22 O <br /> <br />TOTAL ASSETS <br />j22 ~ NET WORTH <br />l TOTAL LIABILITIES AND NET WORTH 1 1~ <br />S 22~4~)O <br />INCOME CONTINGENT LIA6111TIES <br />SolorY ~ j As Endorser or Comaker j <br />Bonus and Commissions On Looses or Contracts <br />Dividends and Interest Legal Claims <br />Real Estofe Income Provision for Federal Income Tax <br />Alimony child support or separate maintenance income need not bs <br />reveal <br />d i~ <br />d <br />t <br />i <br />h t <br />h <br />i <br />d Other Special Debt <br />you <br />w <br />e <br />o no <br />s <br />ave <br />o <br />t consi <br />erod as a basis for repaying <br />an obligation. <br />Alimony, child support, separate maintenance received under: <br />^ Court order ^ Written agreement ^ Gral understanding <br />C>ther <br />TOTAI INCOME j <br />INSURANCE COVERAGE COMPARISON OF MONTHLY INCOME ANO EXPENSES <br />Fire Insurance-Buildings ~ j QQQQ Net Monthly Income j <br />Household Effects and Autos 2QQQQ Rent or Home Payment- j~'~ <br />Liability Insurance-Automobiles B~I QQ ~QQ Food and Utilities <br />Personal Incidentals ' <br />General Public Avg. Amt- Paid on Open Accts. <br />~ <br />Other Insurance ~ <br />iOTAI EXPENSES i ji 7f~~ <br />DIFFFRFNfF eFl'WFCN lur'nue sun ev eeuett i t <br />- - __ __ - ~ <br />The federal Reserve Bonk of Dallas does not warrant that this Form meets current or future Federal Regulations. We urge you fo consult with your bank's attorneys <br />on future us• of this form in its present format or your own revision. <br />F-140.00130 (Rev 9/801 <br />