                         [BALANCE SHEET]
Date Compiled___/___/___Compiled by:_______________________
======================================================================
ASSETS
                                             Present Year  Prior Year
Current Assets
     Cash (in hand, in banks)                ____________ ____________
     Marketable securities                   ____________ ____________
     Accounts receivable (less bad debts)    ____________ ____________
     Inventories                             ____________ ____________
     Prepayments                             ____________ ____________
     Investments (at cost)                   ____________ ____________
                    Total current assets:
======================================================================
Fixed Assets
     Land                                    ____________ ____________
     Buildings                               ____________ ____________
     Machinery                               ____________ ____________
     Office equipment                        ____________ ____________
     Subtotal                                ____________ ____________
          Less depreciation                  ____________ ____________
                           Net fixed assets:
======================================================================
          Other assets and deferred charges:
======================================================================
      Intangibles (goodwill, patents, etc.):
======================================================================
                               Total assets:
======================================================================
LIABILITIES
Current Liabilities
     Accounts payable                        ____________ ____________
     Notes payable (due within one year)     ____________ ____________
     Accrued expenses payable                ____________ ____________
     Taxes payable                           ____________ ____________
                  Total current liabilities:
======================================================================
Long-term Liabilities
     Interest (notes payable after
     one year)                               ____________ ____________
                          Total liabilities:
======================================================================
Stockholders' Equity
     Preferred stock                         ____________ ____________
     Common stock                            ____________ ____________
     Accumulated retained earnings           ____________ ____________
                 Total stockholders' equity:
======================================================================
  Total liabilities and stockholders equity:
======================================================================



