PROPERTY STATEMENT

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v.	CASE NO.	_______________
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ITEM		POSSESSION		W VALUE		H VALUE
REAL ESTATE:				_________		_________

MOTOR VEHICLES:
_____________	VIN	______________	___	________	_________
_____________	VIN	______________	___	________	_________
_____________	VIN	______________	___	________	_________
_____________	VIN	______________	___	________	_________
_____________	VIN	______________	___	________	_________

RECREATIONAL ITEMS (BOATS, TRAILERS, ETC.)
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________

HOUSEHOLD GOODS:
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BANK ACCOUNTS, IRA’S, RETIREMENT ACCOUNTS, TIER II ACCOUNTS, LIFE INSURANCE POLICIES WITH CASH VALUE, STOCKS, BONDS, ETC.:

(Include Acct. Numbers and Name and Address of Bank, Insurance Co., etc.)

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DEBTS OF MARRIAGE:

Secured: (List item of property secured.)

_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________

Unsecured:

_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
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ASSETS BROUGHT INTO MARRIAGE:

(List only those items still in the possession of one of the parties or those items that have been sold and the proceeds of sale are directly traceable to present assets of the parties and have not become co-mingled with the entire marital estate.)

ASSETS WIFE BROUGHT INTO MARRIAGE:

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ASSETS HUSBAND BROUGHT INTO MARRIAGE:

_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
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_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________

DEBTS WIFE BROUGHT INTO MARRIAGE:

_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________

DEBTS HUSBAND BROUGHT INTO MARRIAGE:

_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________
_____________________________________	___	________	_________

* Indicates desired by H # Indicates desired by W