Case File
efta-efta01136153DOJ Data Set 9OtherFINANCIAL ANALYSIS SUMMARY
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Unknown
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DOJ Data Set 9
Reference
efta-efta01136153
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FINANCIAL ANALYSIS SUMMARY
Leon D. Black
President and Managing Member
Hamlet Holdings LLC
Date
STATEMENT OF ASSETS
PREVIOUS
NET WORTH
CURRENT
SUBMITTED
NET WORTH
U0=4
3(31/15
Ditbramat
lisibann
Comments
Please complete the detailed schedules listed for all of the assets, both tangible and intangible. heti by you. your spouse and your Dependent Children. on the appropriate schedule as noted below.
Enter the amount as of the date of this Statement. All listed assets must be described fully on the appropriate schedules attached. The -totals" should transfer from the detailed schedules to this
summary page.
STATEMENT OF LIABILITIES
Please complete the detailed schedules listed for all of the liabilities of yoursetl, your spouse and your Dependent Children, on the appropriate schedule as noted below. Enter the amount as of the
date of this Statement. Al listed liabdities must be deserted fully on the appropriate schedules attached. The 'totals' should transfer from the detailed schedules to this summary page.
EFTA01136153
Schedule A - Cash in Banks
Hame(.). Address & Telephone 0
Nansels) APPeallad
Applcant: Loan D. Black
Accaunil
DON
hPe al
Waal
oaxa
CImM
EFTA01136154
Name(s), Address & Telephone 0
Manx(s) Appearing
Account
Date
Type of
Interest
Date of
Current
TOTAL:
EFTA01136155
Schedule B • Accounts & Notes Receivable
Name. Address & Telephone
Number of Debtor
Date
Original
Incurred
Amount
TOTAL: S
Applicant Leon D. Black
Unpaid
Interest
Maturity
Balance
Rate
Date
Pur
se
NOTE THAT AS PART OF RECENT ESTATE PLANNING. LEON D. BLACK ENTERED INTO VARIOUS TRANSACTIONS WITH FAMILY TRUSTS.
THESE TRANSACTIONS GIVE RISE TO RECEIVABLES AND PAYABLES BY LEON D. BLACK TO FAMILY GRANTOR
TRUSTS FOR WHICH LEON D. BLACK IS GRANTOR FOR INCOME TAX PURPOSES. THESE INTRA•FAMILY TRANSACTIONS
ARE ZERO SUM TRANSACTIONS AS ANY RECEIVABLE IS EQUAL TO A PAYABLE. FOR REPORTING PURPOSES. THESE TRANSACTIONS ARE NETTED.
Collateral Securing
Account or Note
EFTA01136156
Schedule C - Stocks, Bonds. Notes & Debentures
Name of Issuing Company
Type of
No. of
of
Applcani. Leon D. Black
Purchase
Date of
Nome al
Annual
Curren?
Prosy Plebe
Dab of
EFTA01136157
Marne of Neuing Company
Type of
Ma. of
ff. of
PUIChiSO
Date of
Narne
Mnual
Cunenl
PIoaPPMUgo
Date of
TOTAL:
hl
EFTA01136158
SS;Mu11'IP
n- BP ininoss InvesimeatA
Business Irovtirnen.
Type a
Ho. ol
PveNse
Dale of
000ICIAt 1.00A D.131Ek
Saw le
%el
EFTA01136159
Susness Irrresiment
Type et
I
rt n
ND al
Pwcr., re
Oa* et
Name in
Annual
wren
'1/2 el
Ouriness
Pr.
Ve
NNeh Nei
• or,
p
nl
inn.
TOTAL: $
EFTA01136160
Schedule E - Real Estate
Applicant: Leon D. Black
Address
ft Street. Clt & Si.. Parcel Lot 11
Owner of
Property
Purchase
Record
T •e
Pricer Date
Encumbrances
Annual
% of
Income
Ownereht
Current Value
of % Owned
Names of Other
Owners & %Owned.
TOTAL:
EFTA01136161
Schedule F - Life Insurance
Name. Address & Telephone is
of Insurance Carrier
Policy
Date
Number
Issued
Applicant: Leon D. Black
Beneficiary(ies)
Face
Value
Annual
Premiums
TOTAL: $
Cash Surrender
Value
EFTA01136162
Schedule G - Pension / Retirement Funds
Name Appearing
Type of
Type of Securities
on Account / Fund Account I Fund Held b Account / Fund
Em • lo =r / Institution
Number
Contributions
Contributions
Value
Applicant: Leon D. Black
Name & Address of
Account / Fund
Employee
Employer
Current
TOTAL: n=
EFTA01136163
Schedule H - Vehicles
T
of Vehicle
Specify if
Date of Purchase
LA_p_plicant: Leon D. Black
Model
Cimed'Leased
or Lease A• regiment
Year
Make & Model
of Vehicle
Purchase Price!
Current Market Value
Cost of Lease
If Owned
TOTAL: S
EFTA01136164
Schedule I - Other Assets
of Asset
Date of
Purchase
Applicant: Leon D. Black
Purchase
Price
% of
Current Market
Ownershl •
Value of % Owned
TOTAL:
Other
Information
EFTA01136165
Schedule
Accounts Payable
Applicant: Leon D. Black
Name. Address & Telephone
Date
Number of Creditor
Account Number
Incurred
Due
Date
Interest
Monthly
Rate
Payment
'0
S
Unpaid
Balance
EFTA01136166
Schedule K - Taxes Payable
Nature
Date
AppLcart: Leon D. Brack
Original
Fines. Penalties &
Taxin • Authorit
of Tax
Due
Obli • ation
Interest, If An
Total Amount
Due
TOTAL
S
Other
Information
EFTA01136167
Schedule L - Notes & Loans Pavables
Name. Address & Telephone
Date
Original
.
41
.
nu.
I
Unpaid
Applicant: Leon D. Black
Payment
Interest
Maturity
r• so • •
•
; •
o.•
TOTAL
$
EFTA01136168
Schedule M - Mortgages Liens Payable on Real Estate
Applicant: Leon D. Black
Name. Address & Telephone
Date
Original
Monthly
Unpaid
Interest Maturity
Number of Creditor! Account if
Incurred
Amount
Pa ment
Balance
Rate
Date
Address of Real Estate
lien! Mort
TOTAL
a
Description
Position of
EFTA01136169
Schedule N - Other Liabilities
Name. Address & Telephone
Date
Original
TOTAL
Unpaid
Applicant: Leon D. Black
Payment
Interest
Maturity
Description amiror
EFTA01136170
Schedule 0 - Conti n aent Liabilities
Apptcant Leon D. BIad
Name. Address & Telephone
Date
Original
Unpaid
Payment
Interest
Maturity
DescantIon anceor
Number of Parties
Intuited
Amount
Balance
Amount i Ponied
Rate
Date
Conatetal
Purpose of Liability
TOTAL
EFTA01136171
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