1. SECTION 3: STOCKS AND BONDS
Number of Market Value Date of
Name of Securities Cost Total Value
Shares Quotation/Exchange Quotation/Exchange
SECTION 4: REAL ESTATE OWNED
Property A Property B Property C
Type of Property
Name & Address of Title Holder
Date Purchased
Original Cost
Present Market Value
Name & Address of Mortgage Holder
Mortgage Balance
Amount of Payment (Month/Year)
Status of Mortgage
SECTION 5: OTHER PERSONAL PROPERTY AND OTHER ASSETS
SECTION 6: UNPAID TAXES
SECTION 7: OTHER LIABILITIES
(Face amount, cash surrender value, insurance company and
SECTION 8: LIFE INSURANCE HELD
beneficiary)
Signature: Date: Social Security Number:
Signature: Date: Social Security Number:
No warranty or representation, express or implied, is made as to the accuracy of the information contained herein, and same is submitted subject to
errors, omissions, change of price, rental or other conditions, withdrawal without notice, and to any special listing conditions, imposed by our principals.
2. CLIENT PARTNERS
TENANTS
Aerosoles Gander Mountain
Aveda Salon & Spa Gap, Inc.
Bath & Body Works Gelazzi
Black Walnut Cafe Global Restaurant Systems
The Boardroom Salon Goddard Systems
Borders Books & Music Harry’s Pacific Grill
Boston’s Pizza HomeGoods
Butterfly Life Houlihan’s
Capital One Bank Imagination Toys & Shoes
Catherine’s IO Metro
Celebrity Bakery K & G Men’s Center
Cigar Vault Kiddie Academy
Clearwire Lane Bryant
Crate & Barrel Lakeshore Learning Stores
Cyclone’s Mexican Restaurants Larry North Fitness
Darden Restaurants Lidia’s Italy
Red Lobster Life Time Fitness
Olive Garden Marshall’s
Longhorn Steakhouse McCormick & Schmick's
Seasons 52 Music Go Round
Bahama Breeze MW Cleaners
Denny’s Northern Tool + Equipment
Downtown Locker Room Old Navy
Dunn Bros. Coffee Omaha Steaks
Elephant Bar Restaurants Once Upon a Child
Eye Masters Original Soupman
Exhale Spa Perfumania
Fashion Bug Petite Sophisticate
Fatburger Plato’s Closet
Fleming’s Prime Steakhouse & Wine Bar Play It Again Sports
Freshii PLS Finacial Services
Games Workshop Poblanos Mexican Grill
2700 Post Oak Boulevard, Suite 325 Houston, Texas 77056
T 713.595.9500 F 713.595.9501 www.page-partners.com
PAR TNERS
