Spreadsheet: 816384d4-371c-4b19-8214-5aa5a0f988a1
Sheet: Sheet1

FINANCIAL STATEMENT OF: | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | AMERICAN  BANK, N.A. | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26 | Unnamed: 27 | Unnamed: 28
Name___________________________
Name___________________________ |  |  |  |  |  |  |  | Le Mars, Iowa    and   [NAME], Iowa
Address_________________________
________________________________
 |  | ASSETS |  |  |  |  |  |  | LIABILITIES |  |  |  |  | SCHEDULE A - REAL ESTATE - RENTED
 |  |  |  |  |  |  |  |  |  |  |  |  |  | RENTED LAND/OWNER: |  |  | [NAME] | CASH/SHARE | ACRES |  | $/ACRE |  | $/YEAR
CASH |  |  |  |  |  |  |  | NOTES PAYABLE - BANK |  |  | CATTLE |  |  |  |  |  |  |  |  |  |  |  | 0
SAVINGS, BONDS |  |  |  |  |  |  |  |  |  |  | HOGS |  |  |  |  |  |  |  |  |  |  |  | 0
A/R |  |  |  |  |  |  |  |  |  |  | OPERATING |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  | OTHER NOTES |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
 |  |  |  |  |  |  |  | TO: |  | COVERING: |  |  |  |  |  |  |  |  |  |  |  |  | 0
GRAIN/FEED |  | AMOUNT | UNIT | PRICE | TOTAL |  |  | TO: |  | COVERING: |  |  |  |  |  |  |  |  |  |  |  |  | 0
CORN |  |  | BU. |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
BEANS |  |  | BU. |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0
HAY |  |  | TON |  | 0 |  |  | ACCOUNTS PAYABLE: | TO WHOM: |  |  |  |  |  |  | TOTALS |  |  | 0 |  |  |  | 0
OATS |  |  | BU. |  | 0 |  |  | GAS & OIL
HAYLAGE |  |  | TON |  | 0 |  |  | REPAIRS |  |  |  |  |  | SCHEDULE B - LIFE INSURANCE
OTHER/STRAW |  |  | [NAME] |  | 0 |  |  | FEED
 |  |  |  |  |  | 0 |  | FERTILIZER |  |  |  |  |  | INSURANCE CO. |  |  | BENEFICIARY | FACE VALUE | KIND |  |  |  | CASH-VALUE | DEBT |  | PREMIUM
 |  |  |  |  |  |  |  | VET
CROP/INPUTS | ACRES | YIELD | PRICE | VALUE | TOTAL |  |  | DEBT TO RELATIVES
CORN |  |  |  |  | 0 |  |  | INSURANCE
BEAN |  |  |  |  | 0 |  |  | TAXES
HAY |  |  |  |  | 0 |  |  | CASH RENT
STRAW |  |  |  |  | 0 |  |  | CUSTOM HIRE |  |  |  |  |  | SCHEDULE F - MACHINERY, EQUIPMENT AND FIXTURES
TOTAL | 0 |  |  |  |  | 0 |  |  |  |  |  |  |  | CARS/TRUCKS |  |  |  |  |  | I
 |  |  |  |  |  |  |  |  |  |  |  |  |  | YEAR | MAKE | KIND | DESCRIPTIONS |  | VALUE | I | YEAR | MAKE | KIND | DESCRIPTIONS |  | VALUE
LIVESTOCK | HEAD | WEIGHT | $/CWT | $/HD | TOTAL |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 | I
CATTLE |  |  |  | 0 | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I |  |  | WAGON
 |  |  |  | 0 | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I |  |  | WAGON
 |  |  |  | 0 | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  | 0 | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I |  |  | ELEVATOR
HOGS |  |  |  | 0 | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I |  |  | AUGER
 |  |  |  | 0 | 0 |  |  | ACCRUED INTEREST |  |  |  |  |  |  | AUTOS SUB-TOTAL |  |  |  | 0 | I
 |  |  |  | 0 | 0 |  |  |  |  |  |  |  |  | EQUIPMENT |  |  |  |  |  | I |  |  | FERT SPEADER
 |  |  |  | 0 | 0 |  |  |  |  |  |  |  |  |  |  | TRACTOR |  |  |  | I
 |  |  |  | 0 | 0 |  |  | PRINCIPAL PAYMENTS ON TERM DEBT: |  |  |  |  |  |  |  | TRACTOR |  |  |  | I
 |  |  |  | 0 | 0 |  |  | INTERMEDIATE PRINCIPAL PAYMENTS |  |  |  |  | 0 |  |  | TRACTOR |  |  |  | I
 |  |  |  | 0 | 0 |  |  | LONG TERM PRINCIPAL PAYMENTS |  |  |  |  | 0 |  |  |  |  |  |  | I |  |  | SPRAYER
 |  |  |  | 0 | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  | 0 | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  | 0 | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  | 0 | 0 |  |  | CONTINGENT OR COSIGNED LIABILITIES($ |  |  |  | ) |  |  |  |  |  |  |  | I
TOTAL | 0 |  |  |  |  | 0 |  | FOR: |  |  |  |  |  |  |  |  |  |  |  | I | MACHINERY SUB-TOTAL |  |  |  |  | 0
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | PICKER |  |  |  | I
 | TOTAL CURRENT ASSETS |  |  |  |  | 0 |  |  | TOTAL CURRENT LIABILITIES |  |  |  | 0 |  |  | COMBINE |  |  |  | I |  |  | GRIND/MIXER
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | HEADS |  |  |  | I
MACHINERY, EQUIP  (SCHED F.) LESS( |  |  | 0 | )DEPREC. |  | 0 |  | NOTES & CONTRACTS | PAYMENT | FREQ-DATE | P+I/P | RATE | BALANCE |  |  |  |  |  |  | I |  |  | MANURE SPREAD
CARS, TRUCKS |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  | CHOPPER |  |  |  | I
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | CHISEL |  |  |  | I |  |  | DRYER EQUIP
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | DISC |  |  |  | I |  |  | LOADER
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | PLOW |  |  |  | I
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | DISC |  |  |  | I
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | CULTIVATOR |  |  |  | I
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I |  |  | FEEDERS
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I |  |  | GAS TANKS
BREEDING STOCK |  | HEAD | $/HEAD |  | TOTAL |  |  |  |  |  |  |  |  |  |  | PLANTER |  |  |  | I |  |  | CORN BINS
 |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  | DRILL |  |  |  | I
 |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  | CULTIVATOR |  |  |  | I
 |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  |  |  |  |  |  | PRINCIPAL PYMTS DUE IN 6 MONTHS  --- |  |  |  | 0 |  |  |  |  |  |  | I
LEASE EQUIPMENT  VALUE-----------> |  |  |  | ($ |  | )  xxxxxxxxxxxxxx |  |  |  |  |  |  |  |  |  | WINDROWER |  |  |  | I
CASH VALUE LIFE INS.(SCH B.) |  |  |  |  |  | 0 |  | LIFE INSURANCE (SCH. B) |  |  |  |  | 0 |  |  | BALER |  |  |  | I
 | TOTAL INTERMEDIATE ASSETS |  |  |  |  | 0 |  |  | TOTAL INTERMEDIATE LIABILITIES |  |  |  | 0 |  |  |  |  |  |  | I |  |  | TOOLS/MISC
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | I
REAL ESTATE |  |  | ACRES | $/ACRE | COST | VALUE |  | MORTGAGE/CONTRACT | PAYMENT | FREQ-DATE | P+I/P | RATE | BALANCE |  |  |  |  |  |  | I | EQUIPMENT SUB-TOTAL |  |  |  |  | 0
 |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  | I | TOTAL |  |  |  |  | 0
 |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  | I
 |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  | TRACTOR |  |  |  | I
 |  |  |  |  |  | 0 |  |  |  |  |  |  |  | RATIOS AND ANALYSIS |  |  |  |  |  | OTHER INFORMATION
 |  |  |  |  |  | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  | 1. | OFF FARM |  | WIFE:
 |  |  |  |  |  | 0 |  |  |  |  |  |  |  | A. | CURRENT ASSETS |  | 0 |  |  |  | INCOME: |  | HUSBAND:
 |  |  |  |  |  | 0 |  |  | PRINCIPAL PYMTS DUE IN 6 MONTHS  --- |  |  |  | 0 | B. | CURRENT LIABILITIES |  | 0 | CA : CL = | 0 | 2. | CHILDREN AT HOME:
TOTAL |  |  | 0 |  |  |  |  |  |  |  |  |  |  | C. | CURRENT MARGIN(A-B) |  | 0 | CL : NW = | 0 | 3. | HEALTH INSURANCE? |  |  | YES | $ AMOUNTS:
 | TOTAL LONG TERM ASSETS |  |  |  |  | 0 |  |  | TOTAL LONG TERM LIABILITIES |  |  |  | 0 | D. | TOTAL ASSETS |  | 0 | TL : NW = | 0 | 4. | PROPERTY INSURANCE? |  |  | YES
 |  |  |  |  |  |  |  |  |  |  |  |  |  | E | TOTAL LIABILITIES |  | 0 | TL : TA = | 0 | 5. | LIABILITY INSURANCE? |  |  | YES
 |  |  |  |  |  |  |  |  | TOTAL LIABILITIES |  |  |  | 0 | F | NET WORTH(D-E) |  | 0 |  |  | 6. | ARE YOU OBLIGATED TO PAY ALIMONY OR CHILD SUPPORT? |  |  |  |  |  | NO
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 7. | HAVE YOU EVER BEEN INVOLVED IN BANKRUPTCY? |  |  |  |  | NO
 |  |  |  |  |  |  |  |  | PRESENT NET WORTH |  |  |  | 0 |  |  |  |  |  |  | 8. | ARE THERE ANY LAW SUITS PENDING AGAINST YOU? |  |  |  |  | NO
 | TOTAL ASSETS |  |  |  |  | 0 |  |  | TOTAL LIABILITIES & NET WORTH |  |  |  | 0
 |  |  |  | The undersigned  borrower(s) acknowledge receipt of a copy of this instrument.
I/We have carefully read the contents of the above statement and certify that the same is a true statement of the facts as My/Our financial condition.  I/We authorize the above bank
to inquire to any creditor about my present or past obligations and credit history.  I/We hereby agree to an on farm inspection by the above bank at any time.
 |  |  |  |  |  |  |  | X
 |  |  |  |  |  |  |  |  | Name___________________________
DATED: |  |  |  |  |  |  |  | X
 |  |  |  |  |  |  |  |  | Name___________________________
/PPCRRA1..N104~AGPQ
ALT-S/PPCRRQ1..AD90~AGPQ