Statement of Affairs (SOA 1) Debtor Debtor ID Date NAMA Held Assets & Liabilities Name of Entity Entity % of ownership Asset Location (1) Asset Description (2) Bank/ Lender (3) Value £ (4) Valuation basis (5) Valuation Date (6) Debt Limit £ (7) Debt Drawn Balance £ (8) Net Value £ (9) Annual Income £ (10) Annual Holding Costs £ (11) Annual Surplus Cash £ (12) Annual Debt Servicing (13) Debt Service Agreement (17) Debt Expiry Date (18) Guarantee £(19) Guarantor Name(20) Guarantee Type(21) Interest (14) £ Capital Repayment £ (15) Total Commitment £ (16) Sub Total Other Bank/Lender Held Assets & Liabilities Name of Entity Entity % of Ownership Asset Location To include Folio Number or details of predecessor /previous Owner (If applicable) Asset Description Bank/ Lender Value £ Valuation Basis Valuation Date Debt Limit £ Debt Drawn Balance £ Net Value £ Annual Income £ Annual Debt Servicing Annual Holding Costs £ Surplus Cash £ Debt Service Agreement Debt Expiry Date Guarantee £ Guarantor Name Guarantee Type Interest £ Capital Repayment £ Total Commitment £ Sub Total Unencumbered Assets (22) Properties NAME OF ENTITY Entity % of Ownership Asset Location To include Folio Number or details of predecessor /previous Owner (If applicable) Asset Description Value £ Valuation Basis Valuation Date Annual Income £ Annual Holding Costs £ (If applicable) Surplus Income £ Sub Total Bank Accounts Account Name Account Number Sort Code IBAN Bank Name & Address Account Type Balance £ Balance Currency Sub Total Cash (232)
Sub Total Any Other Assets & Liabilities (including Tax), in Which Borrower (or related entity (30)) Has Legal or Beneficial Interest NAME OF ENTITY Entity % of Ownership Asset or Liability Location To include Folio Number or details of predecessor /previous Owner (If applicable) Asset or Liability Description Bank/ Value £ Valuation Basis Valuation Date Debt Limit £ Debt Drawn Balance £ Net Value £ Annual Income £ Annual Debt Servicing Annual Holding Costs £ Annual Surplus Cash £ Debt Service Agreement Debt Expiry Date Interest £ Capital Repayment £ Total Commitment £ Sub Total Other Income [All Other Income not Identified in Tables Above] NAME OF ENTITY Borrower % of Ownership Income Source (31) Borrower Annual share of Income £ (32) Borrower annual share of Holding costs £ (33) Borrowers Annual share of Surplus Income £ (34) Income Duration (35) Date of Last Tax Return (36) Tax Status Category (37) Sub Total Overall Connection Net Worth and Liquidity Position Total Value (38) Total Liability (39) Net Value (40) Total Income (41) Total Repayment (42) Total Annual Holding Costs (43) Surplus Cash (44) £ £ £ £ £ £ £ Contingent Assets & (Liabilities) (including personal/corporate guarantees) nature of Contingent Asset or Liability (45) From (46) To (47) Amount £ (48) Due Date (49) Expiry Date (if any) (50) Status (51) Contractual Assets and Obligations Nature of Contract From To Amount £ Due Date Expiry Date (if any) Status Asset Transfers (52) To Third Parties since January 1st, 2006, including all transfers to Family and/or related parties (Other Than Arm’s Length Transactions in Good Faith to Independent, Unconnected Third Parties for Valuable Consideration at Full Open Market Value) Asset Location Asset Description From Entity % of Ownership pre Transfer (53) To Value of Asset £ (54) Consideration for Transfer (55) Date of Transfer (56) Reason for Transfer (57)