hp 7 YL, ADDRESS. \7 2 CORPORATIONS as apopteo ame CE FoR STATEMENT OF FORM ARD 5 i ee TO METROPOLITAN On FOR A, pe BANK, FOURTH ae AVE. AND YORK BANKERS STATE ASSOCIATION Ee 23d ST., NEW YORK OF PROCURING CREDIT FROM TIME TO TIME WITH YOU FOR OUR NEGOTIABLE PAPER OR OTHERWISE, WE —__190,____, WHICH YOU ARE TO CONSIDER sai FURNISH THE FOLLOWING AS A TRUE AND ACCURATE STATEMENT OF OUR FINANCIAL CONDITION ON ______ IN CONSIDERATION OF GRANTING ANY CREDIT BY SAID BANK, THE UNDERAS CONTINUING TO BE FULL AND ACCURATE UNTIL WE GIVE YOU WRITTEN NOTICE OF CHANGE. SIGNED AGREE THAT IN CASE OF FAILURE OR INSOLVENCY ON THE PART OF THE UNDERSIGNED, OR IN THE EVENT OF IT APPEARING AT ANY TIME THAT ANY OF THE FOLLOWING REPRESENTATIONS ARE UNTRUE, OR IN THE CASE OF THE OCCURRENCE OF SUCH CHANGE AS AFORESAID OR OF FAILURE TO NOTIFY SUCH CHANGE AS ABOVE AGREED, ALL OR ANY OF THE CLAIMS OR DEMANDS AGAINST THE UNDERSIGNED HELD BY SAID BANK, SHALL, AT THE OPTION THEREOF, IMMEDIATELY BECOME DUE AND FURTHER, THAT THE EXERCISE OF OR OMISSION TO EXERCISE SUCH OPTION IN ANY INSTANCE SHALL NOT WAIVE OR AFFECT ANY OTHER OR SUBSEQUENT PAYABLE. RIGHT TO CASH on EXERCISE THE am NEW sy PURPOSE THE -SAME/ Foe LOG Piss —<— HAND LIP ee Se CASH IN THE FOLLOWING me Pe Perr nab ees Berean pare ERAS | pee Bytha | NOTES RECEIVABLE NOTES ano ACCOUNTS ue “ MACHINERY “ce customers (nor or customers RECEIVABLE or orricers LiGWw vAgERORGi (How vatueo—____ USED Not BUSINESS (Not 3S ee TRANSFERRED) Pa eos 2 FOR THIS BUSINESS : 1) RBAL OES ree PLEDGED NoTES RECEIVABLE OTHER coNTINGENT or ASSIGNED OTHER INSURANCE: perdhs: ‘ LIABILITY: on mercuanvise ano RESULTS: asre transrerReD) UNFINISHED “ E a (not TRANSFERRED) RAW MATERIAL BY CORPORATION, ee Vogt | cok MRR ee Siaeh pene CONTINGENT Have a FiNisHED OWNED Buitpineas We or RECEIVABLE MERCHANDISE LAND Gt BS SE any ies Be BONDED Ae | or customers DISCOUNTED DEBT (wuen DEBT CHATT we MORTGAGES____— or LIABILITY oF THE aBove ACCOUNTS RECE AMOUNT TO ASSETS USED AS COLLATERAL $_ SINGS ANNUAL SALES For THE YEAR el ENDED co ee Rr ite Agente EXPENSE or CONDUCTING NET Ba ee INCOME, COMBINED PAID DIVIDENDS rae AUTHORIZED. ae Pla, ‘ INSURANCE es ee rece FOR THE SAME PERIOD BUSINESS INCLUDING INVESTMENTS AOE as, TOTAL Ne PROFIT ror THE perion ———__ FOR THE PERIOD DEBTS __. og PROFIT OTHER CAPITAL: vue MorT@aace GROSS PROFITS on SALES BAD MERCHANCISE | fabs Feet age ACCOUNTS S aiven For hA// AYABLE necoriatep TO OWN BANKS | NAME OF BANK m NOTES*PAYABLE cgi vias cs ae, i | PRES GMS PLR, SA Se e0kaeO ee ree Nae a ars ri RR, i Daas a VS A AL BE: Soci Stores sea HAne __ ISSUED BANK ACCOUNTS: wuere BONDS KEPT OTHER MORTGAGES ano average TERMS on wuich we SELL averace TERMS on we TIME OF YEAR wen TIME OF YEAR wren STOCKS TIME OF YEAR WHEN wuich on wnat THAN ABOVE Assets A LIEN BUY NOTES ano ACCOUNTS of LIABILITIES RECEIVABLE MERCHANDISE ARE MAXIMUM UNCOLLECTED, oF CUSTOMERS, ARE GENERALLY gazes sei MINIMUM MN MM on nanp are GENERALLY MAXIMUM peated MAXIMUM MINIMUM_____——— (OVER)