Fee Calculator

When calculating the "current" values, use the balance as of the date that you are filling out this form.

Enter values as whole numbers without dollar signs or cents. (example 100,000)

1) Real Property net value (Fair Market Value - note balance or balances = net value)
	Common Address	Current Value
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2) Cash and Accounts with Financial Institutions Balances
	Name of Instition	last 4 dig. of Acct. #	current balance
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3) Motor Vehicles, Boats, Airplanes, Cycles etc. net value (Fair Market Value - note balance = net value)
	Make and Model	Current Net Value
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4) Retirement Benefits/IRA/SEP (defined contribution plan or defined benefit plan)
	Name of Account	Current Value of Account
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5) Insurance and Annuities
	Company Name of Insurer	Current Cash Value
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6) Brokerage/Mutual Fund Accounts
	Name of Company	Current Balance
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7) Stocks, Bonds, & other Securities
	Name of Issuer	Current Value
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8) Closely Held Business
	Name of Business	Current Business Value
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9) Unsecured Debt
	Name of Debt Holder	Current Liability Amount
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