Page 4 of U-Save Rental Franchise Application by U-Save Car & Truck Rental

u-save auto rental of america inc personal financial statement please type or print/may attach financial statements assets cash on hand and in banks us gov securities see schedule a marketable securities see schedule a control securities see schedule a loans receivable real estate mortgages receivablesecured by real estate mortgages deed of trust see schedule b real estate owned see schedule c autos and other personal property cash value life insurance see schedule d liabilities notes payable to others secured notes payable to others unsecured accounts and bills due unpaid income tax other unpaid taxes interest real estate mortgages payable see schedule c notes payable to banks secured notes payable to banks unsecured other assets business equity 401k ira s etc chattel mortgages other liens payable other debts itemize total liabilities net worth total assets total liabilities net worth total assets must equal total liabilities net worth the sections below must be completed sources of income salary bonus commissions dividends real estate income other income itemize are you an owner partner or officer in any other venture yes no if yes explain personal information are any assets pledged or encumbered by a lien mortgage or security interest see schedule e are you a defendant in any suits or legal actions total income yes no if yes explain contingent liabilities as endorser co-maker or guarantor other special debt on leases or contracts legal claims contested income tax liens have you during the 15 year period immediately preceding the date of this application been adjudged a debtor in bankruptcy or reorganized personally or professionally due to insolvency yes no if yes when and explain:

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