Form IA 6251B Fillable Balance Sheet or Statement of Net Worth 41-135
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

annuities certificate of deposit accounts checking accounts credit union accounts gasoline credit card balances individual retirement accounts installment obligations long term loans (over one year) mortgages other charge card balances other credit or installment balances pensions Railroad Retirement benefits real estate transactions savings accounts Social Security benefits (Click to clear form) Reset Form (Click to print form) Print Form (text) (text) (text) (text) (text) (text) (text) (text) (text) *1341135019999* 1 Total Cash 1 Total Cash 1 10 Other Personal Property 10 Other Personal Property 10 11 TOTAL ASSETS Add lines 1 10 11 11 TOTAL ASSETS: 12 Current Liabilities 12 Current Liabilities 12 13 Long Term Liabilities 13 Long Term Liabilities 13 14 Accrued Taxes 14 Accrued Taxes 14 15 TOTAL LIABILITIES 15 TOTAL LIABILITIES Add lines 12 14 15 16 Total Assets less Total Liabilities Subtract line 15 from line 11 16 17 Divide Total Liabilities (line 15) by Total Assets (line 11) 17 2 Securities 2 Securities 2 3 Pensions IRAs and Social Security Benefits 3 Pensions IRAs and Social Security Benefits 3 4 Insurance Policies 4 Insurance Policies 4 41 135a (08/10/11) 41 135b (07/02/13) 5 Accounts Receivable 5 Accounts Receivable 5 6 Inventory Crops and Livestock 6 Inventory including crops livestock other farm animals and poultry 6 7 Real Property 7 Real Property 7 8 Machinery and Equipment 8 Machinery and Equipment 8 9 Vehicles 9 Vehicles 9 Add lines 1 through 10 and enter your total assets Add lines 12 through 14 and enter your total and pans etc antiques etc appliances such as washer dryer refrigerator As of assets line 11 and enter your debt to asset ratio on Balance Sheet/Statement of Net Worth bank card account balances basis of the accounting method used by the taxpayer beds dressers sofa chairs dining room set charges for dental or medical care Complete each section as follows Be sure to include the crops livestock other farm animals and poultry Divide your total liabilities line 15 by your total eliminating the distressed sale transaction from net equipment IA 6251B 20 IA 6251B Instructions Include all cars trucks recreational vehicles Include the balance of your cash accounts both Include the current balance of all your accounts Include the current retail value of all vehicles Include the current value of all life insurance Include the current value of all your stocks bonds Include the current value of the following: Include the following: Include the market value of all machinery and Include the market value of all your inventory Include the market value of any real estate both Include the total of any money due to you both income and those limiting their tax liability to their net instruments firearms jewelry collectibles etc Iowa Department of Revenue items such as paintings pictures musical liabilities on line 15 line 17 loans loans for seed fertilizer supplies etc ) motorcycles etc Name(s) net worth on line 16 Note: The balance sheet should be completed on the notes etc on line 11 owed both personal and business such as: PART A: ASSETS PART B: LIABILITIES PART C: NET WORTH PART D: DEBT TO ASSET RATIO personal and business personal and business assets and liabilities of both personal and business such as: policies spouses IA 6251B should be completed by those Subtract your total liabilities line 15 from your such as silverware coffee maker china pots television stereo stove etc the current market value of all furniture such as the current market value of all household the current market value of all kitchen items the current market value of all other household the total of any loans (insurance loans vehicle total assets line 11 and enter the difference as your worth www iowa gov/tax