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D. ASSETS <br />ALL INFORMATION SHOULD BE CALCULATED ON AN ANNUAL BASIS <br />1. YES ❑ NO ❑ , Do you have any "of the following: checking or savings accounts, Money <br />Market funds, Trusts, IRA/Keogh accounts, Certificates' of Deposit (CDs), <br />stocks, bonds, real estate, or other income -producing assets? If you <br />answered "YES," describe all such accounts below. <br />Asset Summary <br />Type of Asset <br />Account Number <br />or Other Description <br />Where Held <br />Balance/ <br />* Fair <br />Market <br />Value (A) <br />Interest Rate <br />income <br />(g) <br />Total of <br />Column (A) <br />Total of <br />Column (B) <br />" Fair Market Value is the value of the asset minus reasonable costs that were or would be incurred in <br />selling or converting the asset. to cash. These costs include: (1) penalties for early withdrawal; (2) <br />broker/legal fees assessed to sell or convert the asset to cash; and (3) settlement costs for real estate <br />transactions. <br />3. YES ❑ NO ❑ 'Do you own any stocks or bonds? <br />Type/Name <br />4. YES ❑ NO ❑ Do you own any real estate . including a primary residence, farm, . <br />vacation home, vacant land, rental property, or other investments? <br />If yes, please explain: <br />Certain `documents such as an accepted offer to purchase, and/or an <br />O. 4`0%&"M�vmv 1 1 A J-^. <br />