FORM 3 (6/92)
BALANCE SHEET
Debtor: _________________ Case No: _______________
Month Ending: _________________
ASSETS: Current Mo. Prior Mo. At Filing
Cash: __________ _________ _________
Inventory: _________ _________ _________
Accounts Receivables: __________ _________ _________
Insider Receivables
Land and Buildings: __________ _________ _________
Furniture, Fixtures and Equip: __________ _________ _________
Accumulated Depreciation: -(_______) -(______) -(______)
Other: __________ _________ _________
Other: __________ _________ _________
TOTAL ASSETS: __________ _________ _________
LIABILITIES: __________ _________ _________
Postpetition Liabilities:
Accounts Payable: __________ _________ _________
Wages and Salaries: __________ _________ _________
Taxes Payable: __________ _________ _________
Other: __________________ __________ _________ _________
TOTAL Postpetition Liab. __________ _________ _________
Secured Liabilities:
Subject to Postpetition
Collateral or Financing Order __________ _________ _________
All Other Secured Liab. __________ _________ _________
TOTAL Secured Liabilities: __________ _________ _________
Prepetition Liabilities:
Taxes and Other Priority Liab. __________ _________ _________
Unsecured Liabilities: __________ _________ _________
Other: _________________ __________ _________ _________
TOTAL Prepetition Liab __________ _________ _________
Equity:
Owners' Capital: __________ _________ _________
Retained Earnings-Pre Pet. __________ _________ _________
Retained Earnings-Post Pet. __________ _________ _________
TOTAL Equity: __________ _________ _________
TOTAL LIABILITIES
AND EQUITY: __________ _________ _________
FORM 3 (6/92)