FORM # 6 SUMMARY OF ASSETS

FORM # 6 ASSET CHECKLIST

CONFIDENTIAL DISCLOSURE

SUMMARY OF PROPERTY AND RIGHTS TO PROPERTY

AS OF THIS DATE
THIS INFORMATION IS CONFIDENTIAL AND GOES ONLY TO THE LAW OFFICES OF MORGAN D. KING
TODAY'S DATE AND TIME:

MonthDayYearHourMinutesAM/PM Option
WHO IS FILLING OUT THIS FORM?

The taxpayerA relative of the taxpayerA professional on behalf of a taxpayerOther status
If not the taxpayer, does taxpayer give the person filling this out permission to communicate with Mr. King's office?

YesNoOther
If someone other than the taxpayer is filling out this form please give name and connection with the taxpayer:
TAXPAYER'S NAME:
TAXPAYER'S PHONE #:
This phone number is a:

Regular phoneCell phoneOther phone
TAXPAYER'S E-mail ADDRESS:
IN WHAT STATE DO YOU RESIDE?
HAVE YOU HAD A CONVERSATION WITH MR. KING'S OFFICE??

YesNo
IF NO, EXPLAIN WHY YOU ARE FILLING OUT THIS FORM:
A. REAL PROPERTY (land - real estate)
1. DO YOU OWN OR HAVE AN INTEREST IN ANY REAL PROPERTY (land, buildings, home, rental property etc.)?:

YESNO
IF YES, WHAT PROPERTIES DO YOU OWN OR HAVE AN INTEREST IN:

1. A home that I (we) own where I (we) currently reside (not including trailors, mobile homes, or boats)2. One or more residential rental properties that you own or have an interest in.3. One or more commercial properties that you own or have an interest in4. An interest in a real estate LLC, partnership, trust or corporation5. One or more undeveloped parcels that you own or have an interest in6. A timeshare7. Are you expecting an inheritance or bequest of real property in the near future??8. A trailor, boat, or mobile home in which you currently reside9. Other real property
1. If yes, what is your $ estimate of ALL the properties you own or have an interest in? (equity means the total value of all properties, less all mortgages, liens, other encumbrances etc.).
2. What is your $ estimate of equity in the rental properties (equity is value less mortgages, liens, etc):
3. What is the estimated value of your equity in any commercial properties?
4. If yes, what is your $ estimate of the value of your interest in the equity, LLC, real estate partnership, or real estate corporation?
5. What is the estimated value of your equity in any undeveloped land?
6. What is the estimated value of your equity in a timeshare?
7. Do you own any stocks, bonds, or securities of value?
7a Estimated Value of stocks, bonds, or securities:
8. Est. value of your equity in a trailor, boat, or mobile home used as your residence::
9. Estimated value of any stocks, bonds, or other securities you may own.
B. PERSONAL PROPERTY (not real estate)
a. Do you own one or more Motor vehicles

YesNo
a. IF yes, please estimate the $ value of all vehicles less any balances owed on them. In other words, subtract from the Bluebook value the balance of the installment agreement (if any)
Pleased provide the make, model, and year of each vehicle:
Est. equity in jewelry
Est. equity of antiques, art, collections, etc.
Est. equity of clothing of unusual value
Est. equity of sports equip-ment and vehicles (market value less balance owed)
Est. equity of boats & airplanes (market value less balance owed)
Est. equity of computers and other IT equipment and internet assets (market value less balance owed)
Est. equity of household appliances (market value less balance owed)
Est. values of IRAs, annuities, and similar investment funds.
Est. value of other securities (stocks, mutual funds, etc.)
Est. value of horses, dogs, birds, and other animals of unusual value
Est. equity of musical instruments (pianos, violins, guitars etc.)
Est. equity of scientific instruments used for personal or household purposes (telescopes, microscopes, etc.)
Est. equity of household furniture and furnishings (value less balance owed)
Current value of stock options (if not included with "stocks" above). This question asks for what you could get if you cashed in your options today:
Litigation: Est. of claim or suit payoff
Net value less taxes - Pending insurance payoff
Est. Value of patents, etc.
Total of all bank account balances as of the date you filled out this form):
Est. of expected bonus
Est. amount of pending tax refund
Est. equity of taxpayer's share of community property division
Pending sales commissions for real estate agent, insurance broker, stock broker, etc.
Est. values of other personal assets not listed above:
What kind of pension or retirement plans do you currently have?

IRASEP-IRAKeoghProfit-sharingDefined benefitH.R. 10 plan401(k)AnnuitiesOtherNone
Est. value of vested pension and retirement plans:
Est. present loan value of pension or retirement plans:
Est. cash-out or loan value of life insurance policies:
C. OTHER PERSONAL PROPERTY

If you check any asset below, please enter the estimated value in the corresponding box below.
b. Other personal property NOT LISTED ABOVE)

Jewelry $ _________Antiques, art, collections, hobbies$ _________Clothing of unusual value$ _________Sports equipment and vehicles$ _________Boats or planes$ _________IRA retirement accounts$ _________Horses, dogs, birds, other animals of unusual value $ _________Musical equipment, trumpets, pianos, violins etc. $ _________Furniture, art, and furnishings of unusual value$ _________Legal claim or suit that may result in money to you$ _________Pending insurance pay-off (e.g. fire, theft, car accident)Patents, trademarks, copyrights$ _________Cash in one or more bank accounts$ _________Bonus expected this year$ _________Tax refund$ _________ expectedMoney owed to you$ _________Other personal property$ _________
C. BUSINESS PROPERTIES

(including real and personal property not already

listed in "A" or "B" above)
Do you own a business or own an interest in a business?

YesNoOwned until recently
Did you own a business that is no longer operating?

YesNoOther
When did the business cease operating?
What is the structure of your business?

None or not applicableLimited liability corporation ("LLC")General partnershipLimited (silent) partnershipIncorporatedSole proprietorshipOther business interest or structure
If incorporated - what state was it incorporated in?
What does (did) your business do?

ServicesProductsBoth services and productsOther
What are the principal assets in connection with your business??

FranchiseVehiclesProductsSuppliesReal propertyValuable contractsAccounts receivableIntellectual property (patents, web sites, etc.)Cash in bank accountsOffice furniture, furnishings, equipmentTools of the trade (hand tools, books, calculators etc.)Transferrable licenses and permits (e.g., a liquor license)Other business or income-producing assetsNo business assets or not-applicable
If a franchise - what is the current value? (i.e. if you sold it what would you get for it)?
What permits and licenses do you have?

Beer, wine, liquorCity or county business licenseTrade license (taxi driver, locksmith, beautician, gun sales, etc.)ContractingFinancial (advising, stock broker, etc.)Media (radio, television, etc.)Insurance agentReal estate sales/brokerFood processingResaleProfessional (law or medical)Other license or permit
Describe business assets not included in the above list.
Est. value of your equity in all business assets (except income-producing properties already listed in section ""A" or "B" above):
D. TRANSFERS - TITLE - PURCHASES
Have you transferred title to any real property, motor vehicles, or other items having "title" to any other person (including spouse) in the last 2 years?

YesNo.Uncertain
Explain transfers made in the last 2 years:
Have you purchased any real estate, vehicles, or other valuable items in someone else's name in the last 2 years??

YesNoUncertain
Explain purchases made in someone else's name::
Have you deposited any of your income into a bank account in someone else's name in the last 2 years?

YesNoUncertain
If yes, please explain your reasons for such deposits:
In the last 2 years have you given or transferred title to any real estate, vehicles or other valuable property to a relative (child, parent, sibling etc.)?

YesNoNo sure
Please explain what property was transferred to a relative, the identity of the relative, and the circumstances around it.
Have you created a trust or a corporation within the last 10 years?

NoYes - a trustYes - a corporation
Did you transfer any assets or property to the trust?

YesNoNot sure
Transfers to the trust: If yes, please describe:
Please describe or explain any other information about your property or assets that you believe may be relevant to matters involving your property, or your business' property, and that you think Mr. King should know about:
Enter any questions you may have of Mr. King in connection with any of your answers to any of the questions on this form:
DO YOU GIVE MR. KING'S OFFICE PERMISSION TO DO AN ONLINE PUBLIC RECORDS SEARCH TO VERIFY SOME OF THE INFORMATION YOU ENTERED ON THIS FORM:

YesNoWant to discuss this with Mr. King's office first.
THESE ARE THE KINDS OF RECORDS THAT MAY BE VIEWED: PLEASE CHECK THE KINDS OF PUBLIC RECORDS MR. KING'S OFFICE MAY CONTACT:

Online search for liens, judgments, title to property, etc.Credit reportMedical records (if relevant to your matter)Tax recordsAll of the above
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