Free 1007-3 Financial Review of the Debtor's Business - Minnesota

Form 1007-3 - Financial Review of the Debtor's Business In re:_____________________ Case No. __________ Chapter ______

FINANCIAL REVIEW OF THE DEBTOR'S BUSINESS (NOTE: ONLY INCLUDE information directly related to one business operation on each form) Type of business________________ Business Name________________

PART A - GROSS BUSINESS INCOME FOR PREVIOUS 12 MONTHS: 1. Gross Income for 12 Months Prior to Filing $_______

PART B - ESTIMATED AVERAGE FUTURE GROSS MONTHLY INCOME: 2. Gross Monthly Income: $_______

PART C - ESTIMATED AVERAGE FUTURE MONTHLY EXPENSES: 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. Payroll (paid to others) $_________ Payroll Taxes $_________ Unemployment Taxes $_________ Worker's Compensation $_________ Employee Benefits (e.g., pension medical, etc.) $_________ Other Taxes $_________ Inventory Purchases (including raw materials) $_________ Purchase of Feed/Fertilizer/ Seed/Spray $_________ Rent (Other than debtor's principal residence) $_________ Utilities $_________ Office Expenses and Supplies $_________ Repairs and Maintenance $_________ Vehicle Expenses $_________ Travel and Entertainment $_________ Advertising and Promotion $_________ Equipment Rental and Leases $_________ Legal/Accounting/Other Professional Fees $_________ Insurance $_________ Payment to Be Made Directly by $_________ Debtor to Secured Creditors $_________ for Pre-Petition Business $_________

22. 23.

Debts (specify) $_________ Other (describe) $_________ Total Monthly Expenses (add items (3-22)) $________

PART D - ESTIMATED AVERAGE NET MONTHLY INCOME: 24. Average Net Monthly Income (subtract line 22 from line 2) Net Monthly Income

$________ $________

Verification. I, ____, the debtor(s) named in the foregoing financial review form, declare under penalty of perjury that the foregoing is true and correct according to the best of my knowledge, information and belief. Executed on ________________ Signed:_______________________ Name and Address of Subscriber