Form B1, Exh.A (9/97)
Exhibit "A" to Voluntary Petition
1. If any of the debtor's securities are registered under Section 12 of the Securities Exchange Act of 1934, the SEC file number is _______________. 2. The following financial data is the latest available information and refers to the debtor's condition on ______________. a. b. Total assets Total debts (including debts listed in 2.c., below) $ _____________________________ $ ______________________________ Approximate number of holders c. Debt securities held by more than 500 holders. secured / /
secured / / unsecured / / unsecured / / unsecured / / unsecured / / unsecured / / subordinated / / subordinated / / subordinated / / subordinated / / subordinated / / $ _________________________ $__________________________ $ _________________________ $__________________________ $__________________________ _______________ _______________ _______________ _______________ _______________
secured / /
secured / / secured / /
d. e.
Number of shares of preferred stock Number of shares common stock
_______________________ _______________________
_____________ _____________
Comments, if any: _____________________________________________________________________
3.
Brief description of debtor's business: ____________________________________________________
4. List the names of any person who directly or indirectly owns, controls, or holds, with power to vote, 5% or more of the voting securities of debtor: