LLC
WORKSHEET REGARDING PROPERTY AND DEBT
The information below will be helpful to have prior to mediation
Name: _______________________________________________________________________
Date of marriage: ______________________________________________________________
ASSETS
Real Estate:
Marital Residence:
Address: __________________________________________________________
Purchased
before marriage by _____________
during marriage
Purchase date and price:______________________________________________
Value on date of marriage (if purchased by one party prior to marriage):_________________
How valued: _______________________________________________________
Current value: ______________________________________________________
How valued: _______________________________________________________
Amount owed: 1st Mortgage: _______ 2nd Mortgage: ________ Other:_________
Monthly payments on mortgage(s): _____________________________________
How titled: _______________________________________________________
Other Real Estate: (attach additional pages if necessary)
Address: __________________________________________________________
Purchased
before marriage by _____________
during marriage
Purchase date and price:______________________________________________
Value on date of marriage (if purchased by one party prior to marriage):_________________
How valued: _______________________________________________________
Current value: ______________________________________________________
How valued: _______________________________________________________
Amount owed: 1st Mortgage: _______ 2nd Mortgage: ________ Other:_________
Monthly payments on mortgage(s): _____________________________________
How titled: ________________________________________________________
Address: __________________________________________________________
Purchased
before marriage by _____________
during marriage
Purchase date and price:______________________________________________
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Value on date of marriage (if purchased by one party prior to marriage):_________________
How valued: _______________________________________________________
Current value: ______________________________________________________
How valued: _______________________________________________________
Amount owed: 1st Mortgage: _______ 2nd Mortgage: ________ Other:_________
Monthly payments on mortgage(s): _____________________________________
Motor Vehicles and/or Recreational Vehicles:
(attach additional pages if necessary)
Year/Make/Model: ________________________________________________________
Purchased
before marriage by _____________
during marriage
Purchase date and price :____________________________________________________
Current value: ____________________________________________________________
How valued: _____________________________________________________________
How titled: ______________________________________________________________
Current Loan Amount: _____________________________________________________
Monthly Payment: ________________________________________________________
Primarily used by: ________________________________________________________
Year/Make/Model: ________________________________________________________
Purchased
before marriage by _____________
during marriage
Purchase date and price :____________________________________________________
Current value: ____________________________________________________________
How valued: _____________________________________________________________
How titled: ______________________________________________________________
Current Loan Amount: _____________________________________________________
Monthly Payment: ________________________________________________________
Primarily used by: ________________________________________________________
Year/Make/Model: ________________________________________________________
Purchased
before marriage by _____________
during marriage
Purchase date and price :____________________________________________________
Current value: ____________________________________________________________
How valued: _____________________________________________________________
How titled: ______________________________________________________________
Current Loan Amount: _____________________________________________________
Monthly Payment: ________________________________________________________
Primarily used by: ________________________________________________________
Bank Accounts:
Name of bank: ____________________________________________________________
Type of account:__________________________________________________________
Account balance: _________________________________________________________
Name(s) on account: ______________________________________________________
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Name of bank: ____________________________________________________________
Type of account:__________________________________________________________
Account balance: _________________________________________________________
Name(s) on account: ______________________________________________________
Name of bank: ____________________________________________________________
Type of account:__________________________________________________________
Account balance: _________________________________________________________
Name(s) on account: ______________________________________________________
Stocks, Bonds, Mutual Funds & Investment Accounts (not pension or retirement accounts):
(attach additional pages if necessary)
Name of stock, bond, mutual fund or account: __________________________________
Purchased
before marriage by _____________
during marriage
Value on date of marriage (if purchased by one party prior to marriage):_______________________
Current value: ____________________________________________________________
Pension, Profit Sharing or Retirement Accounts:
(attach additional pages if necessary)
Name of account or fund: __________________________________________________
Type of account: _________________________________________________________
Name of participant: ______________________________________________________
Current value: ____________________________________________________________
Date employment began: ___________________________________________________
Date employment ended: ___________________________________________________
Name of account or fund: __________________________________________________
Type of account: _________________________________________________________
Name of participant: ______________________________________________________
Current value: ____________________________________________________________
Date employment began: ___________________________________________________
Date employment ended: ___________________________________________________
Name of account or fund: __________________________________________________
Type of account: _________________________________________________________
Name of participant: ______________________________________________________
Current value: ____________________________________________________________
Date employment began: ___________________________________________________
Date employment ended: ___________________________________________________
Furniture, Household Goods, Other Personal Property:
If the furniture, household goods, or other personal property has not already been divided
to your mutual satisfaction, list on separate sheet(s) each item as to which there is no
agreement and its approximate current value (what you could sell it for). Put a star by
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anything on the list you claim is your separate property (see Colorado Revised Statute 14-10113(2)).
Life Insurance:
(attach additional pages if necessary)
Name of company: ________________________________________________________
Type of policy:
Term
whole life
Cash value (if any): ____________________________________________________________________
Beneficiary: _____________________________________________________________
Miscellaneous Assets:
Please list any other assets not listed above.
Debts:
Name of creditor: ________________________________________________________
Current balance: _________________________________________________________
Name(s) on account: ______________________________________________________
Date account opened (approximate): ____________________________________________________
Monthly payment: ________________________________________________________
Paid by: ________________________________________________________________
Name of creditor: ________________________________________________________
Current balance: _________________________________________________________
Name(s) on account: ______________________________________________________
Date account opened (approximate): ____________________________________________________
Monthly payment: ________________________________________________________
Name of creditor: ________________________________________________________
Current balance: _________________________________________________________
Name(s) on account: ______________________________________________________
Date account opened (approximate): ____________________________________________________
Monthly payment: ________________________________________________________
Paid by: ________________________________________________________________
Name of creditor: ________________________________________________________
Current balance: _________________________________________________________
Name(s) on account: ______________________________________________________
Date account opened (approximate): ____________________________________________________
Monthly payment: ________________________________________________________
Paid by: ________________________________________________________________
Taxes:
current
not current
If not current, amount and years owed? ________________________________________
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