Financial Review Of Debtors Business {1007-3}

LOCAL FORM 1007-3 UNITED STATES BANKRUPTCY COURT DISTRICT OF MINNESOTA In re: Debtor(s). FINANCIAL REVIEW OF THE DEBTOR'S BUSINESS (NOTE: ONLY INCLUDE information directly related to one business operation on each form) Type of business Business Name Case No. PART A - GROSS BUSINESS INCOME FOR PREVIOUS 12 MONTHS: 1. Gross Income for 12 Months Prior to Filing $ PART B - ESTIMATED AVERAGE FUTURE GROSS MONTHLY INCOME: 2. Gross Monthly Income: $ PART C - ESTIMATED AVERAGE FUTURE MONTHLY EXPENSES: 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. Payroll (paid to others) Payroll Taxes Unemployment Taxes Worker's Compensation Employee Benefits (e.g., pension, medical, etc.) Other Taxes Inventory Purchases (including raw materials) Purchase of Feed/Fertilizer/ Seed/Spray Rent (Other than debtor's principal residence) Utilities Office Expenses and Supplies Repairs and Maintenance Page 1 of 2 $ $ $ $ $ $ $ $ $ $ $ $ American LegalNet, Inc. www.FormsWorkFlow.com LOCAL FORM 1007-3 15. 16. 17. 18. 19. 20. 21. 22. 23. Vehicle Expenses Travel and Entertainment Advertising and Promotion Equipment Rental and Leases Legal/Accounting/ Other Professional Fees Insurance Payment to Be Made Directly by Debtor to Secured Creditors for Pre-Petition Business Debts (specify) Other (describe) Total Monthly Expenses (add items 3-22) $ $ $ $ $ $ $ $ $ $ $ PART D - ESTIMATED AVERAGE NET MONTHLY INCOME: 24. Average Net Monthly Income (subtract line 22 from line 2) $ Net Monthly Income $ Verification. I, , the debtor(s) named in the foregoing financial review form, declare under penalty of perjury that the foregoing is true and correct according to the best of my knowledge, information and belief. Executed on: Signed: Print Name: Address: Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com