INCOME QUESTIONNAIRE FOR THE 36 MONTHS FROM NAME AND LOCATION OF PROPERTY
GOLF COURSE INCOME AND EXPENSE QUESTIONNAIRE
2006 TO 2008 OWNER AND ADDRESS OF RECORD
Check course characteristics: Driving Range( ) Practice Green( ) Cart Paths( ) Club House ( ) Pro Shop ( ) Type of Grass Width of Fairways Water Source _______ USGA sanctioned ( ) #Tees/hole #Water Hazards Longest Yardage______ Par _____ Slope _____ Type of Irrigation Initiation Fee for New Members __ _ __ Are Fees Refundable? _ ___ Number of Members __ ___ Number of Holes ____ Rates per round (including cart): Weekday _ __ Weekend __ _ Twilight _ _ 9 Hole ____ Number of rounds played Annual Income:
Membership Fees
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$___ $_______ $___ $___ $___ $___ $___ $___ $___ ______ ______ ______ ______ ______ ______ ______ ______
2008
____________
$____ __ _ $______ ___ $____ __ _ $____ __ _ $____ __ _ $____ __ _ $____ __ _ $____ __ _ $____ __ _ __ __ __ __ __ __ __ __ __
2007
_________
$__ $__ $__ $__ $__ $__ $__ $__ _______ _______ _______ _______ _______ _______ _______ _______
2006
Expenses: Cost of Goods Sold: Food Beverage Pro Shop Cart Expense Practice Fac. Exp. Other Expenses: Payroll Payroll Taxes Marketing Management Fee Administrative Insurance Course Maintenance Building Repairs Electricity Amusement Tax Water/Sewer Misc. Expenses Total Expenses: Net Operating Income: Real Estate Taxes Mortgage Payments Building Depreciation Reserves for Replacement Capital Expenditures (list)
Greens fees Cart rental Food Beverage Pro Shop Practice Facilities Other Income Total
$___________
$___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___ $___
______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______
$____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____ $____
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__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
$__ $__ $__ $__ $__
_______ ______ _ ________ ________ ________
$____________ $__ ________ $__ ________ $__ ________ $__ ________ $__ ________ $__ ________ $__ ________ $__ ________ $__ ________ $__ ________ $__ ________ $__ ________ $__ $__ $__ $__ $__ ________ ________ ________ ________ ________
MORTGAGE & SALES INFORMATION 1. Is there a mortgage on this property? Yes ____ No ____ 2. If "Yes", please provide the following data: (a)____________________________ Name of Mortgagee (d)________________ Term of Mortgage 3: Date Purchased: _____________ (b)______________ Mortgage Amount (c) _____________ Interest Rate
(e) __________________ Date 1st Payment
(f) _________________ Monthly Payment
Consideration: _____________
I declare, under the penalties of perjury, that the contents of this form and all accompanying schedules and statements have been examined by me and are true, correct, and complete to the best of my knowledge, information, and belief.
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Signature
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Date
Title of Signer ____________________ Phone Number
___________________________________________ Print/Type Name of Signer