Fillable ! ! ASSET%LIST% Please!provide!a!list!of!all!assets!currently!owned!by!the!business.!!List!each!item!ind ivid u a lly!along!with!its!estimated!market!value.!!All!items!listed!with!an!

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! ! ASSET%LIST% Please!provide!a!list!of!all!assets!currently!owned!by!the!business.!!List!each!item!ind ivid u a lly!along!with!its!estimated!market!value.!!All!items!listed!with!an!

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The ! ! ASSET%LIST% Please!provide!a!list!of!all!assets!currently!owned!by!the!business.!!List!each!item!ind ivid u a lly!along!with!its!estimated!market!value.!!All!items!listed!with!an! form is 3 pages long and contains:

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! ! ASSET%LIST%
Asset!List!v!2.0!–!Confidential! May!2020!
E"X"A"M"P"L "E"
Please!provide!a!list!of!all!assets!currently!owned!by!the!business.!!List!each!item!ind ivid u a lly!along!with!its!estimated!market!value.!!All!items!listed!with!an!
original!purchase!cost!greater!than!$5,000!must!include !manufacture r!Y e ar /Make/Model!and!Serial/ID!Number.!
Assets!can!include,!but!are!not!limite d!t o :!
• Electronic!equipment!(i.e.!computers,!prin te r s,!fa x!m a ch ines ,!external!hard!drives,!servers,!laptops,!etc.) %
• Office!furniture!(i.e.!file!cabinets,!desks,!chairs,!etc.)%
• Tools!and/or!appliances!used!for!business!purposes!only!(i.e.!construction!equipment,!removable!restaurant!pieces,!etc.)%
• Vehicles!and!machinery!(i.e.!trucks,!trailers,!tractors,!etc.)%
%
**%Please%use%a%separate%page%for%each%of%your%business%locations.%**%
%
BUSINESS%NAME:%ABC!Corporation!
ASSET%LOCATION:%123!Main!Street,!San!Francisco,!CA!94103!
%
Quantity%
Item%
Description%
Year%/%Make%
/%Model%
Year%
Acquired%
Original%
Cost%
Market%
Value*%
Name%of%
Lienh o ld e r%%
(if%applicable)%
Current%
Lien%
Balance%
Current%Mileage%
(vehicles%on ly)%
1%
Laptop%
Apple%
MacBook%
2016%
$3,000%
$1,000%
N/A%
N/A%
N/A%
1%
X-Ray%
Machine%
Fluoro%OEC%
9600%
2014%
$100,000%
$95,000%
Wells%Fargo%
$40,000%
N/A%
1%
Truck%
2018%Ford%
F150%
2018%
$36,000%
$27,000%
Capital%One%
$14,000%
79,832%
%
* Market value is the price an asset would fetch in the marketplace
!
!
% %
! ! ASSET%LIST%
Asset!List!v!2.0!–!Confidential! May!2020!
BUSINESS%NAME:%!
ASSET%LOCATION:%%!
% % % %
Quantity%
Item%
Description%
Year%/%Make%
/%Model%
Year%
Acquired%
Original%
Cost%
Market%
Value*%
Serial%#%/%ID%#%/%VIN%
Name%of%
Lienholder%%
(if%applicable)%
Current%Lien%
Balance%
Current%Mileage%
(vehicles%on ly)%
%
%
%
%
%
%
%
%
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* Market value is the price an asset would fetch in the marketplace"" "
! ! ASSET%LIST%
Asset!List!v!2.0!–!Confidential! May!2020!
!
CERTIFICATION%
!
I!certify!tha t !all!informa tio n !c o nt ain e d !h er ein !is !T R U E !an d !C O R R E C T !to !th e !b es t!o f!t h e!u n d e rsig n e d ’s!kn o wledge.!%If%yo u %k n o w in g ly %make%a%false%s ta te ment%or%
overvalue%a%security%to% obtain%a%guaranteed%loan%from% the% SBA,% you% can% be%fined%up%to% $10,000% and/or% imprisoned% for% not%more%than% fiv e%years%under% 1 8%USC%
1001;%if%submitted%to%a%Federally%insured%institution,%under%18%USC%1014% by%Imprisonment%of%not%more%than%twenty%years%and/or% a%fine%of%not%m ore%than%
$1,000,000.%I!a u th orize!the!SBA ’s !O ff ice !o f!In s p e ctor!General!to !request!criminal!record!information!ab out!m e!from!crimina l!justice!agencies!for!the!purpose!of!
determining!my!eligibility!for!programs!authorized!by!the!Small!Business!Act,!as!amended.!
!
!
!
!
!
!
Print!Name!&!Title!
!
Signature!
!
Date!
!
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ASSET%LIST% Pleaseprovidealistofallassetscurrentlyownedbythebusiness.Listeachitemind ivid u a llyalongwithitsestimatedmarketvalue.Allitemslistedwithan

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Completed 22 July 2021

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