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Net worth statement should only be used to record the details of personal assets and liabilities. You can fill in the document online and then click the print icon and all of your information will be populated in the printable document, saving you time later. 0000001837 00000 n
For accounts and notes receivable, enter the total value of all monies owed to you personally, if any.
)How Secured or Endorsed Type of Collateral
Section 3. TTY/Assistive Device: 202-366-9696. Business Hours: 8:30am-5:00pm ET, M-F. Share. The financial institutes might ask for the net worth statement before considering your application. If you do not locate the form needed please go to the Public MDOT Forms Page, The DBE Application is available in additional languages (Chinese, Korean, and Spanish), if needed, please contact the Office of Business Development at: 866-323-1264, If Interpretation is needed, please call Orlando T. Curry, MSA at: 517-241-7462. 1200 New Jersey Avenue, SE Washington, DC 20590 855-368-4200. Retirement Accounts, IRA, 401Ks, 403Bs, Pensions: On page 1, enter the full value minus tax and interest penalties that would apply if assets were distributed as of the date of the form. Receive email updates … Proof Required.
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Contingent tax liabilities or anticipated taxes for current year should not be included.
Real Estate Owned (including primary residence, investment properties, personal property leased or rented for business purposes, farm properties or any other income producing property). Your information will not be disclosed to third parties without your consent. Form Coordinator: Denise Cannon. Contingent liabilities do not count toward your net worth until they become actual liabilities. Primary ResidenceProperty BProperty C
Type of Property
AddressDate Acquired and Method of Acquisition (purchase, inherit, divorce, gift, etc.) Washington, DC 20590. It will automatically download when it's ready.
Proof of Good Standing : Proof of Good Standing from the Maryland Department of Assessments and Taxation is required for Maryland domiciled firms and out-of-state firms applying for certification. If necessary, use additional sheets of paper to report all information and details. H��Wَ�F}�W܇!�]���۱
/��AH�M���pQ������Eu��00�Zܪ�v^e�Y��n������.l��IBȚՋ1�sa(�Ջ��x�V�q]7��XѕAv\Yoo>��oﲷ��݇�>��� {{v������}��+���煷��6��n��x�e�Gըv��7ي�(� �����c��j�z�]D�z��e�F��ѺY�W�=.LcZ!�d��-y,���fq�w+�� ��o�����a�;E�7͡V��8��J�;�X)�����n�����������gS^/��w�~v!�.I[��d�~�-N��ECWh;vB+���m ���&@;q�k�#�-����9�o��1�cD�u�7�[�Z���U7�$i፺�|6������:��["�$��kǞ���O9;���ŕ��J>?�?��͒�D��/u��:7��b����V���@|�RW�7?r^1x~=��:��.%���آo%���E���%g��aZ���������_�@��Q�t��ڼr���~��'��\N��(�s�s����^�rM1b�m7*�v��0��j�������M��A� Life Insurance: On page 1, enter the cash surrender value of this asset. If you have any questions about completing this form, please contact one of the UCP certifying agencies. Often times you will need this if you are looking to take out a loan or line of credit from a bank, as they want to know that if things go south, you have enough assets to pay back the loan. The Net Total Assets amount is displayed below the assets table and the Net Liabilities amount is displayed under the Liabilities Table. Proof of Good Standing : Proof of Good Standing from the Maryland Department of Assessments and Taxation is required for Maryland domiciled firms and out-of-state firms applying for certification. Personal property includes motor vehicles, boats, trailers, jewelry, furniture, household goods, collectibles, clothing, and personally owned vehicles that are leased or rented to businesses or other individuals. The amount entered for calculating the assets valuation should include the exact value that you would earn on selling the asset in the market. 0000005121 00000 n
MDOT - DTMB. 1200 New Jersey Ave, S.E. I d e c l a r e u n d e r p e n a l t y o f p e r j u r y t h a t t h e i n f o r m a t i o n p r o v i d e d i n t h i s p e r s o n a l n e t w o r t h s t a t e m e n t a n d s u p p o r t i n g d o c u m e n t s i s c o m p l e t e , t r u e a n d c o r r e c t . U.S. DEPARTMENT OF TRANSPORTATION. 202-366-4043. Personal financial statement provides a realistic listing of the assets we own and the debts we owe. … Personal Net Worth Statement for DBE/ACDBE Program Eligibility: Office of Business Development: 08/2019 Site Link: 0103E: Equal Opportunity Contract Compliance Data Report: Office of Business Development: 06/2018 Fillable: 0103F: MDOT EEO Officer Notification: Office of Business Development: 02/2017 Fillable: 0106 DOT regulations 49 C.F.R.
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