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SECTION 2

Pleas

STATEMENT OF ASSETS

continue on a separate sheet if more space is required, indicating to which que bns the information refers.

1. RESIDENTIAL HOUSES AND APARTMENTS

Address

Full Description Of Property

Value

FOR OFFICIAL USE ONLY

2. COMMERCIAL, INDUSTRIAL AND PROFESSIONAL PREMISES

Full Description Of Property And Its Use

Address

3. FARMS AND AGRICULTURAL LAND

Address

Value

FOR OFFICIAL USE ONLY

Full Description Of Property And Its Use

Value

FOR OFFICIAL USE ONLY

4. LAND (Not included in 1, 2 or 3 above).

Address

Description

Value

FOR OFFICIAL USE ONLY

5. MACHINERY, STOCK IN TRADE, LIVESTOCK, IMPLEMENTS, ETC.

Full Description Of Article

Value

FOR OFFICIAL USE ONLY

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