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AGRICULTURAL FINANCIAL STATEMENT DATE OF STATEMENT: IMORTANT: READ THESE DIRECTIONS BEFORE COMPLETING THIS STATEMENT Amount Current Liabilities Amount Amount Intermediate Liabilities Amount Amount Long Term Liabilities Amount REV 9/14 City: State: Zip: E-mail Address: Supplies (Schedule S2) Market livestock (Schedule B1) Hedging account equity Cash & checking accounts Savings accounts Stocks & bonds Accounts & notes receivable Crops & feed (Schedule A1) Operating loan balances Other Total Current Assets Intermediate Assets Breeding livestock (Schedule B2) Retirement accounts Other Sugar beet stock Titled vehicles (Schedule E) Machinery & equipment (Schedule F) Notes receivable Cooperative dividends Total Intermediate Assets Long Term Assets Farm Real Estate Owned Non-Farm Real Estate Other Total Long Term Assets Total Assets Name: Address: Co-Applicant: Address: Current Assets Prepaid expenses (Schedule S1) City: State: Zip: Investment in growing crops (Schedule A2) Cellular Number: Cash value of life insurance Accounts payable Notes payable Cash rent payable Accrued income and Social Security Taxes Credit card balances Other Total Current Liabilities Lending Institution (Schedule D) Total Liabilities Net Worth Total Liabilities + Net Worth Non-Farm Real Estate Mortgages Other Total Long Term Liabilities Farm Real Estate Mortgages (Schedule G) Total Intermediate Liabilities Individual credit - Please provide financial information only about yourself. Joint credit - Please provide financial information about yourself and the joint applicant. We intend to apply for joint credit. ________________________ _________________________ Applicant Co-Applicant

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AGRICULTURAL FINANCIAL STATEMENTDATE OF STATEMENT:

IMORTANT: READ THESE DIRECTIONS BEFORE COMPLETING THIS STATEMENT

Amount Current Liabilities Amount

Amount Intermediate Liabilities Amount

Amount Long Term Liabilities Amount

REV 9/14

City: State: Zip:

E-mail Address:

Supplies (Schedule S2)

Market livestock (Schedule B1)

Hedging account equity

Cash & checking accountsSavings accountsStocks & bonds

Accounts & notes receivableCrops & feed (Schedule A1)

Operating loan balances

Other

Total Current Assets

Intermediate AssetsBreeding livestock (Schedule B2)

Retirement accounts

Other

Sugar beet stock

Titled vehicles (Schedule E)

Machinery & equipment (Schedule F)

Notes receivable

Cooperative dividends

Total Intermediate Assets

Long Term AssetsFarm Real Estate Owned

Non-Farm Real EstateOther

Total Long Term Assets

Total Assets

Name:

Address:

Co-Applicant:

Address:

Current Assets

Prepaid expenses (Schedule S1)

City: State: Zip:

Investment in growing crops (Schedule A2)

Cellular Number:

Cash value of life insurance

Accounts payableNotes payableCash rent payableAccrued income and Social Security TaxesCredit card balances

Other

Total Current Liabilities

Lending Institution (Schedule D)

Total Liabilities

Net Worth

Total Liabilities + Net Worth

Non-Farm Real Estate Mortgages

OtherTotal Long Term Liabilities

Farm Real Estate Mortgages (Schedule G)

Total Intermediate Liabilities

Individual credit - Please provide financial information only about yourself.

Joint credit - Please provide financial information about yourself and the joint applicant.

We intend to apply for joint credit. ________________________ _________________________Applicant Co-Applicant

Invested

Inventory Amount Unit Price Total Crop Acres Cost Total

Corn bu

Dry Beans cwt

Dry Beans cwt

Beets ton

Soybeans bu

Wheat bu

Hay

Haylage ton

Corn Silage ton

Straw

Total Total

Inventory Qty Price Total Inventory Qty Price Total

Total Total

Market Livestock - Schedule B1 Breeding Livestock - Schedule B2Livestock # Head Weight $/lb Total Livestock # Head $/Head Total

Steers

Hogs

Total Total

Intermediate Liabilities - Schedule DInt. Rate Balance

Total

Titled Vehicles - Schedule EYear Value Prior Lien

Total

Lending Institution Payment Per YearDescription

Description

Crops & Feed - Schedule A Growing Crops - Schedule A1

Prepaid Expenses - Schedule S1

Corn

Dry Beans

Haylage

Straw

Dry Beans

Beets

Soybeans

Wheat

Supplies - Schedule S2

Hay

Other

Chemicals

Fuel

Fertilizer

SeedOther

Sows

BoarsGilts

Chemicals

Fuel

Fertilizer

SeedOther

Cows

Bred Heifers

Open Heifers

Calves

Bulls

Machinery and Equipment - Schedule FYear Value Prior Lien

TotalReal Estate - Schedule G

Market Balance Interest Payment

Description Acres Value 2 X SEV Owing Rate Per Year

DATE: _______________________ BY: _____________________________________________________________

BY: _____________________________________________________________

Lienholder

The foregoing statement and other representations are made by the undersigned for the purpose of obtaining credit and obtaining a loan. Such financial statement and all details pertaining thereto have been carefully gone over by the undersigned, and I hereby

solemnly declare and certify that they set for a true and accurate statement of my financial condition.

Description