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efta-efta01136153DOJ Data Set 9Other

FINANCIAL ANALYSIS SUMMARY

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DOJ Data Set 9
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efta-efta01136153
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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
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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