SCHEDULE “4”
OUTSTANDING
DEBTS INCURRED SEPARATELY
a. List all outstanding debts you have incurred and are separate
b. Attach to this sheet a copy of the most recent bill from each creditor.
c. If the debt is based on a promissory note, attach a copy of the promissory note and mortgage or security agreement.
d. If the debt is based on a written agreement to repay, indicate whether you signed the written agreement.
e. Your comments or explanations:
CREDITOR |
ACCOUNT
NUMBER |
PURPOSE
OF DEBT |
COLLATERAL
GIVEN |
AMOUNT
DUE |
MONTHLY
PAYMENT |
AWARD |
|
1. |
|
|
|
|
|
H/W |
|
2. |
|
|
|
|
|
H/W |
|
3. |
|
|
|
|
|
H/W |
|
4. |
|
|
|
|
|
H/W |
|
5. |
|
|
|
|
|
H/W |
|
6. |
|
|
|
|
|
H/W |
|
7. |
|
|
|
|
|
H/W |
|
8. |
|
|
|
|
|
H/W |
|
9. |
|
|
|
|
|
H/W |
|
10. |
|
|
|
|
|
H/W |
|
11. |
|
|
|
|
|
H/W |
|
12. |
|
|
|
|
|
H/W |
|
13. |
|
|
|
|
|
H/W |
|
14. |
|
|
|
|
|
H/W |
|
15. |
|
|
|
|
|
H/W |
|
TOTAL |
|
|
|
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