Federal Trade Commission v. AMG Services, Inc. et al

Filing 960

ORDER that 786 the Tucker Defendants' Motion for Extension of Time and 792 the Relief Defendants' Motion for Extension of Time are DENIED as moot. FURTHER ORDERED that 808 the Tucker Defendants' Motion to Reconsider is DENIED . FURTHER ORDERED that 810 FTC's Motion to Unseal is GRANTED in part and DENIED in part. The Clerk is ordered to UNSEAL the following documents: Declaration of Natalie C. Dempsey (ECF No. 803-8); OneClickCash Traning Manual (ECF No. 803-9 ); and UCL Team Meeting Minutes (ECF No. 803-10). Blaine Tucker's Living Trust (ECF No. 803-7) will remain filed under SEAL. FURTHER ORDERED that 780 FTC's Motion for Preliminary Injunction is GRANTED pursuant to the terms listed in this Order. Signed by Chief Judge Gloria M. Navarro on 3/31/16. (Copies have been distributed pursuant to the NEF - MMM)

UNITED STATES DISTRICT COURT

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DISTRICT OF NEVADA

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FEDERAL TRADE COMMISSION,

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vs.

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Plaintiff,

AMG SERVICES, INC., et al.,

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Defendants.

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Case No.: 2:12-cv-00536-GMN-VCF
ORDER

Pending before the Court is a Motion for Preliminary Injunction (ECF No. 780) filed by

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The Federal Trade Commission (the “FTC”). Defendants Park 269, LLC and Kim C. Tucker

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(the “Relief Defendants”) and Defendants AMG Capital Management, LLC (“AMG”); Level 5

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Motorsports, LLC; LeadFlash Consulting LLC; Black Creek Capital Corporation; Broadmoor

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Capital Partners; Scott A. Tucker; Nereyda M. Tucker, as Executor of the Estate of Blaine A.

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Tucker (the “Tucker Defendants”) (collectively “Defendants”) filed their respective Responses

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in Opposition (ECF Nos. 796 and 797) on May 26, 2015, one day after the deadline to Respond

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to the FTC’s motion.1 The FTC subsequently filed a timely Joint Reply (ECF No. 803) to both

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Responses.2

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Both the Relief Defendants and the Tucker Defendants filed Motions for Extension of Time (ECF Nos. 786 and
792) requesting permission to extend the Response deadline by two weeks until June 9, 2015. However, the FTC
opposed both these motions and neither group of defendants filed a Response after May 26, 2015. As a matter of
equity, the Court will consider as timely the defendants’ Responses that were filed one day past the deadline.
Further, because the Court will consider the Responses filed by the defendants and no later responses were filed
prior to the requested extended deadline, the Court finds as moot the Motions for Extension of Time.

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Along with its 34-page Reply, the FTC filed a Motion for Leave to File Excess Pages (ECF No. 804) requesting
permission to exceed the 20-page limit for replies set out in Nevada Local Rule 7-4 in light of its need to reply to
both groups of defendants’ Response briefs. This motion was granted by the Court. (Order, ECF No. 807). The
Tucker Defendants subsequently filed a Motion to Reconsider (ECF No. 808) asking the Court to reverse this
decision. However, “[g]iven the district court’s inherent power to control their dockets, whether to grant leave to
exceed the page limits set forth in the Civil Local Rules appears to be at the full discretion of the Court.” Traylor
Bros. v. San Diego Unified Port Dist., No. 08-CV-1019-L WVG, 2012 WL 1019966, at *2 (S.D. Cal. Mar. 26,
2012) (citing United States v. W.R. Grace, 526 F.3d 499, 509 (9th Cir. 2008) (en banc) (noting also that “judges
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Page 1 of 21

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I.

BACKGROUND
This action was brought by the FTC, asserting that the “high-fee, short-term payday

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loans” offered by Defendants AMG, SFS, Inc., Red Cedar Services, Inc., and former Defendant

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MNE Services, Inc. (“Lending Defendants”)3 violated section 5 of the Federal Trade

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Commission Act of 1914, 15 § U.S.C. 45(a)(1), the Truth in Lending Act of 1968, 15 U.S.C.

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§ 1601(a), and Regulation Z, 12 C.F.R. § 1026(a). (Am. Compl. 15:1–20:6, ECF No. 386).

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On December 27, 2012, the Court signed an Order entering the parties’ joint stipulation

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for preliminary injunction and bifurcation. (ECF No. 296). The Bifurcation Order divided the

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litigation into two phases: a liability phase and a relief phase. (Id. 9:1–10:23). During Phase I

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of the proceedings, the Court would adjudicate the merits of the FTC’s claims for violations of

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the FTC Act, TILA, and EFTA. (Id. 9:1–24). During Phase II of the proceedings, the Court

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would adjudicate the remaining issues, including the individual liability of the various

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Defendants. (Id. 10:119). On May 28, 2014, this Court entered an Order (ECF No. 584)

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adopting a Report and Recommendation entered by Judge Ferenbach and granting summary

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judgment in favor of the FTC on two of its four causes of action. Accordingly, the litigation is

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now in Phase II of the proceedings.

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exercise substantial discretion over what happens inside the courtroom”)). Moreover, the Tucker Defendants’
motion fails to present any evidence that the grounds for granting a motion to reconsider exist in this case. See
Sch. Dist. No. 1J, Multnomah Cnty., Or. v. ACandS, Inc., 5 F.3d 1255, 1263 (9th Cir. 1993) (“Reconsideration is
appropriate if the district court (1) is presented with newly discovered evidence, (2) committed clear error or the
initial decision was manifestly unjust, or (3) if there is an intervening change in controlling law.”). Accordingly,
the Motion to Reconsider is denied.

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The FTC also filed a Motion to Unseal (ECF No. 810) four documents (ECF Nos. 803-7, 803-8, 803-9, 803-10)
attached to its Reply as Exhibits, and the Tucker Defendants filed a Response (ECF No. 823). In their Response,
the Tucker Defendants only oppose unsealing Blaine Tucker’s Living Trust (ECF No. 803-7). Because the
Tucker Defendants have demonstrated that compelling reasons exist to maintain that document under seal, the
Court denies FTC’s motion in regard to Blaine Tucker’s Living Trust and grants the Motion in regard to the
remaining documents.

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Because the FTC’s Motion requests a preliminary injunction exclusively against the Tucker Defendants and the
Relief Defendants, SFS, Inc. and Red Cedar Services, Inc. are not affected by this Order.

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In the instant Motion, the FTC seeks a preliminary injunction against the Tucker

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Defendants and the Relief Defendants in the form of an asset freeze and accounting “[i]n light

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of mounting evidence that Defendants have been engaged in a continuous improper dissipation

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of and concealment of assets.” (Mot. for Prelim. Inj. 1:2–4, ECF No. 780). For the reasons set

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forth below, the Court grants the Motion for Preliminary Injunction.

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II.

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LEGAL STANDARD
Under Section 13(b) of the Federal Trade Commission Act (“FTC Act”), the Court may

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grant the FTC a preliminary injunction “[u]pon a proper showing that, weighing the equities

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and considering the Commission’s likelihood of ultimate success, such action would be in the

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public interest.” 15 U.S.C. § 53(b). Section 13(b) of the FTC Act, therefore, “places a lighter

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burden on the Commission than that imposed on private litigants by the traditional equity

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standard.” F.T.C. v. Warner Commc’n, Inc., 742 F.2d 1156, 1159 (9th Cir. 1984). Under this

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more lenient standard, the FTC need not show irreparable harm; instead, it must only

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demonstrate (1) that it is likely to succeed on the merits and (2) that the equities weigh in favor

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of an injunction. Id. at 1160; see also F.T.C. v. World Wide Factors, 882 F.2d 344, 346 (9th

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Cir. 1989).

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A court’s authority to grant injunctive relief under Section 13(b) includes “all the

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inherent equitable powers . . . for the proper and complete exercise” of the court’s equity

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jurisdiction. F.T.C. v. H.N. Singer, Inc., 668 F.2d 1107, 1112 (9th Cir. 1982) (citations

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omitted). One such power is the authority to freeze a defendant’s assets. Id. at 1113; F.T.C. v.

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Evans Prods. Co., 775 F.2d 1084, 1088–89 (9th Cir. 1985). As the Ninth Circuit emphasized in

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H.N. Singer, an order freezing assets is a form of “ancillary relief” rather than a primary

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remedy. See 668 F.2d at 1112–13. “Courts have inherent equitable powers to grant ancillary

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relief, other than a preliminary injunction restraining future violations of the law, when there is

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no likelihood of recurrence.” Evans Prods., 775 F.2d at 1088. “A party seeking an asset freeze

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must show a likelihood of dissipation of the claimed assets, or other inability to recover

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monetary damages, if relief is not granted.” Johnson v. Couturier, 572 F.3d 1067, 1085 (9th

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Cir. 2009).

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III.

DISCUSSION

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A.

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“[T]he burdens at the preliminary injunction stage track the burdens at trial.” Gonzales v.

Likelihood of Success on the Merits

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O Centro Espirita Beneficente Uniao do Vegetal, 546 U.S. 418, 429 (2006). Thus, the burden

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is on the FTC to demonstrate that it is likely to prevail on its claims that: (1) Scott Tucker and

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Blaine Tucker are individually liable; (2) a common enterprise existed among the lenders and

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their entities; and (3) the Relief Defendants are liable. “Because irreparable injury must be

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presumed in a statutory enforcement action, the district court need only . . . find some chance of

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probable success on the merits.” World Wide Factors, 882 F.2d at 347 (internal quotation

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marks omitted).

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The Court finds that the FTC has satisfied its burden of demonstrating probable success
on the merits of its claims, and considers each claim in turn.
1.

Scott Tucker and Blaine Tucker are Personally Liable for Violations of the FTC
Act

Personal liability for violations of the FTC Act fall into two categories: liability for

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injunctive relief and liability for monetary relief. Individuals are liable for injunctive relief if

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they directly participate in the deceptive acts or have the authority to control them. F.T.C. v.

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Publ’g Clearing House, Inc., 104 F.3d 1168, 1170 (9th Cir. 1997); F.T.C. v. Stefanchik, 559

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F.3d 924, 931 (9th Cir. 2009). To subject an individual to monetary liability, the FTC must

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show that the individual had knowledge of the misrepresentations, was recklessly indifferent to

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the truth or falsity of the misrepresentation, or was aware of a high probability of fraud and

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intentionally avoided the truth. Publ’g Clearing House, 104 F.3d at 1171; Stefanchik, 559 F.3d

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at 931. “[T]he extent of an individual’s involvement in a fraudulent scheme alone is sufficient

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to establish the requisite knowledge for personal restitutionary liability.” F.T.C. v. Affordable

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Media, 179 F.3d 1228, 1235 (9th Cir. 1999).

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The evidence produced by the FTC demonstrates that Scott Tucker and Blaine Tucker

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acted with reckless indifference to the truth or falsity or an awareness of a high probability of

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fraud and an intentional avoidance of the truth. Specifically, Scott Tucker, as AMG’s

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president, directed all lending and collection activities, approved lending policies, drafted and

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reviewed loan disclosures and website content, and interacted and entered into agreements with

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third party servicers. (See e.g., Grote Dep. 165:21–166:8, ECF No. 781-28). For his part as

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AMG’s vice-president, Blaine Tucker edited and approved loan disclosures, reviewed content

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appearing on the Lending Defendants’ websites, and had the authority to modify and approve

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consumer call scripts and other lending policies implemented by the loan companies. (See e.g.,

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AMG Resp. to Interrog. No. 9, ECF No. 781-29). Further, both Scott Tucker and Blaine

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Tucker received periodic reports tracking consumer complaints and were aware that AMG’s

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customers often did not understand the Lending Defendants’ process of renewals and

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paydowns. (See, e.g., Ex. 30 to Singhvi Decl., ECF No. 781-36). This evidence is sufficient to

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support a preliminary conclusion that Scott Tucker and Blaine Tucker were recklessly

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indifferent to or intentionally avoided the possibility of their representations being false or

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fraudulent.

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2.

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“[E]ntities constitute a common enterprise when they exhibit either vertical or horizontal

Lenders Engaged in a Common Enterprise

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commonality—qualities that may be demonstrated by a showing of strongly interdependent

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economic interests or the pooling of assets and revenues.” F.T.C. v. Network Servs. Depot, Inc.,

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617 F.3d 1127, 1142–43 (9th Cir. 2010). In deciding whether a common enterprise exists,

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courts may consider such factors as whether the companies were under common ownership and

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control; whether they pooled resources and staff; whether they shared phone numbers,

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employees, and email systems; and whether they jointly participated in a “common venture” in

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which they benefited from a shared business scheme or referred customers to one another. Id. at

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1243.
In support of its claim that the Tucker Defendants engaged in a common enterprise, the

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FTC points out that “[t]he Tucker Corporate Defendants, wholly owned and controlled by Scott

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Tucker and Blaine Tucker, shared office space with each other and shared employees with

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AMG.”4 (Mot. for Prelim. Inj. 24:13–14; see also Ex. 57 to Singhvi Decl., ECF No. 57; Cert. of

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Int. Parties, ECF No. 58; Tucker Defs.’ Am. Ans. ¶¶ 10–12, 15, ECF No. 397). Further, the

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FTC also demonstrates that the Tucker Corporate Defendants and the Lending Defendants

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commingled corporate funds through “thousands of exorbitant and seemingly random payments

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made by the [Lending Defendants] to the Tucker Corporate Defendants.” (Mot. for Prelim. Inj.

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24:13–14; see also Ex. 5 to Singhvi Decl. at 5–7, 22–25, 45, 53, 57, 67–70, ECF No. 781-11).
While the Tucker Defendants acknowledge that “[t]he bulk of the Motion [for

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Preliminary Injunction] is devoted to trying to establish that Scott and Blaine Tucker were

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members of the alleged common enterprise,” they neither discuss nor refute the FTC’s evidence

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that the lenders engaged in a common enterprise. (Tucker Defs.’ Resp. 21:10–11, ECF No.

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797). Accordingly, based on FTC’s evidence indicating that a common enterprise existed, and

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the Tucker Defendants’ tacit agreement to this claim by failing to refute it, the Court finds that

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the FTC is likely to succeed in proving that the Tucker Defendants engaged in a common

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enterprise.

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The “Tucker Corporate Defendants” are: AMG; Level 5 Motorsports, LLC; LeadFlash Consulting LLC; Black
Creek Capital Corporation; and Broadmoor Capital Partners.

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3.

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District courts are given broad authority under the FTC Act to fashion equitable

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remedies to the extent necessary to ensure effective relief. Network Servs. Depot, 617 F.3d at

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1141–42. “The broad equitable powers of the federal courts can be employed to recover ill

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gotten gains for the benefit of the victims of wrongdoing, whether held by the original

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wrongdoer or by one who has received the proceeds after the wrong.” S.E.C. v. Colello, 139

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F.3d 674, 676 (9th Cir. 1998). “The creditor plaintiff must show that the [relief] defendant has

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received ill gotten funds and that he does not have a legitimate claim to those funds.” Id. at 677.

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Upon such a showing, the remedy is an equitable monetary judgment in the amount of the

The Relief Defendants are Liable

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funds that the relief defendant received. See id.; see also S.E.C. v. Banner Fund Int’l, 211 F.3d

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602, 617 (D.C. Cir. 2000) (“[D]isgorgement is an equitable obligation to return a sum equal to

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the amount wrongfully obtained, rather than a requirement to replevy a specific asset.”).

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The Relief Defendants received funds derived from the fraudulent activities of the other

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defendants. Kim Tucker received at least $19 million in non-salary payments, usually

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orchestrated by Scott Tucker, originating from a Lending Defendant or a member of the

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common enterprise. (See, e.g., Ex. 109 to Singhvi Decl., ECF No. 781-115). Park 269, wholly

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owned by Kim Tucker and nominal owner of an $8 million mansion in Aspen, Colorado, also

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received payments arranged by Scott Tucker for the property’s purchase, mortgage, property

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taxes, furnishing, maintenance, and housekeeping. (See, e.g., Ex. 118 to Singhvi Decl., ECF

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No. 781-124). Based on this evidence of commingling of funds, and considering that the Court

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has preliminarily found Scott Tucker to be personally liable for violations of the FTC Act, the

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Court finds that the FTC has demonstrated a likelihood of success that it will recover from the

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Relief Defendants.

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B.

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In balancing the equities, public equities receive far greater weight than private equities.

Balancing of the Public and Private Interests

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Affordable Media, 179 F.3d at 1236. Public equities include economic benefits and

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competitive advantages for consumers, and effective relief for the FTC. See Warner Commc’n,

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742 F.2d at 1165. “[W]hen a district court balances the hardships of the public interest against

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a private interest, the public interest should receive greater weight.” World Wide Factors, 882

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F.2d at 347. If the FTC demonstrates a likelihood of success on the merits, “a countershowing

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of private equities alone does not justify denial of a preliminary injunction.” Warner Commc’n,

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742 F.2d at 1165.

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The Court finds that the public equities are substantial and outweigh the private equities

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in this case. As discussed below, the FTC has established that its ability to provide restitution

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to consumers will be severely impaired by the denial of an injunction. While the Tucker

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Defendants insist that living expenses and attorneys’ fees must be excluded from the asset

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freeze, the Court has discretion to impose limited allowances for normal living expenses and

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attorneys’ fees. See, e.g., F.T.C. v. Ideal Fin. Sols., Inc., No. 2:13-CV-00143-JAD-GW, 2014

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WL 4541191, at *2 (D. Nev. Sept. 9, 2014) (“The Ninth Circuit recognizes district courts’

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discretion in civil cases to ‘forbid or limit payment of attorney fees out of frozen assets.’”)

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(quoting Commodity Futures Trading Com’n v. Noble Metals Int’l, Inc., 67 F.3d 766, 775 (9th

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Cir. 1995)). Therefore, the balance of equities favors the FTC.

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C.

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Congress has given district courts equitable authority to order the freezing of assets

Asset Freeze

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under § 13(b) of the FTCA. H.N. Singer, 668 F.2d at 1113. An asset freeze is proper to ensure

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that adequate funds will be available to compensate defrauded consumers. Id. “A party seeking

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an asset freeze must show a likelihood of dissipation of the claimed assets, or other inability to

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recover monetary damages, if relief is not granted.” Johnson, 572 F.3d at 1085. The Court

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must also consider whether the freezing of assets “under certain circumstances . . . might thwart

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the goal of compensating investors if the freeze were to cause such disruption of defendants’

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business affairs that they would be financially destroyed.” Id. (quoting S.E.C. v. Manor Nursing

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Ctrs., Inc., 458 F.2d 1082, 1106 (2d Cir. 1972)).
The FTC has presented sufficient evidence to justify an asset freeze. Not only has it

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shown that the Tucker Defendants are likely to conceal and dissipate assets, but it has also

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shown that a monetary award against the Tucker Defendants exceeds their ability to pay.

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Regarding dissipation and concealment of assets, the evidence demonstrates that the Tucker

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Defendants dissipated funds by writing thousands of checks to their wholly owned companies

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and using corporate assets for personal expenditures, including jet travel, luxury automobiles, a

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vacation home, and personal credit card expenses. (Ex. 66 to Singhvi Decl., ECF No. 781-72;

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Ex. 38 to Singhvi Decl., ECF No. 781-44). Further, between March 2013 and late 2014, the

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Tucker Defendants’ total assets shuffled through numerous financial institutions and ultimately

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decreased by $90 million. (See, e.g., Budich Decl. ¶ 8, ECF No. 782; Ex. 45 to Singhvi Decl.,

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ECF No. 781-51).
Next, regarding the Tucker Defendants’ abilities to pay a monetary reward, the FTC

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estimates that it may recover the following amounts: $340 million to $1.3 billion against the

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Tucker Defendants based on consumer restitution; $400 million against the Tucker Defendants

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if the Court awards disgorgement; and $27 million against the Relief Defendants based on the

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value of unearned payments made to them.5 (Mot. for Prelim. Inj. 27:23–27). Because the total

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The FTC’s consumer harm calculations are based on an analysis of defendants’ consumer loan data and
summarized in the Declaration of Elizabeth Miles (“Miles Declaration”) pursuant to Federal Rule of Evidence
1006. (Mot. for Prelim. Inj. 2:20–21; Miles Decl., ECF No. 781-1). The Tucker Defendants argue that the Miles
Declaration is inadmissible under Rule 1006 because “summaries such as those set forth in the Declaration must
be authenticated by an expert.” (Tucker Defs.’ Resp. 14:8–9). Further, the Tucker Defendants complain that they
“have never been provided [the software used to generate the summaries and] have not been allowed to examine
any of the ‘scripts’ [written] for this software.” (Id. 14:17–18). However, Rule 1006 merely requires that the
“underlying records for which the summaries are made be admissible in evidence, and available to the opposing
party for inspection.” United States v. Rizk, 660 F.3d 1125, 1130–31 (9th Cir. 2011). This standard does not
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assets currently held by the Tucker Defendants and the Relief Defendants do not exceed $125

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million, it is likely that the Court’s judgment would greatly exceed Defendants’ abilities to pay.

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(See Budich Decl. ¶ 8). Finally, an asset freeze would not disrupt Defendants’ businesses as

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they have ceased operations. See H.N. Singer, 668 F.2d at 1113 (finding that “there is no danger

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that the freeze will disrupt the defendants’ business affairs [because] . . . [t]hey are out of

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business”).

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While the Tucker Defendants do not dispute any of these facts, they nevertheless

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maintain that “[t]he FTC has failed to demonstrate the likelihood of dissipation or concealment

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of assets.” (Tucker Defs.’ Resp. 21:8). Principally, the Tucker Defendants argue that the FTC’s

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evidence of dissipation is “‘substantially outdated’ and ‘stale.’” (Id. 21:14) (quoting F.T.C. v.

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Merch. Servs. Direct, LLC, No. 13-CV-0279-TOR, 2013 WL 4094394, at *3 (E.D. Wash. Aug.

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13, 2013)).6 In addition, the Tucker Defendants suggest that no dissipation occurred with

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regard to “[t]he $90 million difference in assets from March to the latter part of 2014 [because

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those funds reflect] tax payments made by or on behalf of the Tucker Defendants.” (Tucker

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Defs.’ Resp. 23:1–3).
However, each of the Tucker Defendants’ arguments are misplaced. Indeed, evidence of

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past dissipation is relevant to and probative of the likelihood of future dissipation. See, e.g.,

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require expert testimony, nor does it require the proponent of the summary to provide its software or disclose the
exact keystrokes used to perform the calculations. See Richardson v. Cheshier & Fuller, L.L.P., No. 6:07-CV256, 2008 WL 5122122, at *4 (E.D. Tex. Dec. 3, 2008) (“[Witness’s] testimony described the contents of a
summary of voluminous business records and the methods she used to create the summary, the admissibility of
which neither party disputes. Such testimony is not considered expert testimony.”). Because the Tucker
Defendants do not argue that the evidence upon which the Miles Declaration was generated is inadmissible or
unavailable to them, the Tucker Defendants’ complaints under Rule 1006 are without merit. The Court further
finds the Tucker Defendants’ additional attacks on the Miles Declaration unpersuasive and unfounded.

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The Tucker Defendants fail to clarify that the court in Merchant Services discussed the relevance of “stale”
evidence in the context of a permanent injunction against future violations of the FTC Act, not—as relevant
here—ancillary relief. Merch. Servs., 2013 WL 4094394, at *3. The Merchant Services court ultimately did
decline to enter ancillary relief in the form of an asset freeze, but based its decision on other grounds. Id. at *4.
This apparent misunderstanding of the difference between an injunction against future violations and ancillary
relief pervades both the Tucker Defendants’ and the Relief Defendants’ Responses to the instant Motion. See,
e.g., Evans Prods., 775 F.2d at 1088.
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Affordable Media, 179 F.3d at 1236–37 (noting defendants’ history of concealing and

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dissipating assets supported likelihood of dissipation finding). In addition, the Tucker

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Defendants cite no case law to support the proposition that funds obtained from deceived

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consumers to reduce their own income tax liability mitigates against a finding of dissipation.

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C.f. F.T.C. v. Crittendon, 823 F. Supp. 699, 704 (C.D. Cal. 1993) aff’d 19 F.3d 26 (9th Cir.

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1994) (funds derived from deception are held in constructive trust for deceived consumers, and

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are not to be used to pay defendant’s taxes). Moreover, as the FTC points out, “if the Tucker

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Defendants’ paid $100 million in income taxes, where are the earnings upon which those taxes

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were assessed?” (Mot. for Prelim. Inj. 24:8–9). Given that the Tucker Defendants appear to

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have had just $212.6 million in assets by the end of March 2013, FTC’s question renders

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Defendants’ explanations doubtful. (See Budich Decl. ¶ 7).
Accordingly, the Tucker Defendants’ conduct establishes a likelihood that in the absence

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of an asset freeze and accounting, asset dissipation and concealment will continue.7 See, e.g.,

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Johnson, 572 F.3d at 1085 (defendant’s past of diverting more than $35 million in company

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assets to his personal bank account created a likelihood of asset dissipation). The Court

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therefore finds that it is necessary to freeze their assets and orders an accounting “to preserve

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the possibility of effective relief.” Reebok Int’l, Ltd. v. Marnatech Enters., Inc., 970 F.2d 552,

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560 (9th Cir. 1992).
Based the forgoing, the Court shall issue a preliminary injunction consistent with the

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definitions set forth below.

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IV.

1. “Asset” means any legal or equitable interest in, right to, or claim to, any real,

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DEFINITIONS

personal, or intellectual property including, but not limited to, chattel, goods, instruments,

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The Tucker Defendants cite no authority to support their contention that the proposed accounting is unjustified
“mandatory relief.” (Tucker Defs.’ Resp. 30:6–13). Instead, the Court recognizes that accountings are frequently
and routinely ordered in conjunction with an asset freeze. See, e.g., Johnson, 572 F.3d at 1085.

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Page 11 of 21

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equipment, fixtures, general intangibles, effects, leaseholds, contracts, mail or other deliveries,

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shares of stock, securities, inventory, checks, notes, accounts, credits, receivables (as those

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terms are defined in the Uniform Commercial Code), cash, trusts, including but not limited to

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asset protection trusts, and reserve funds or other accounts associated with any payments

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processed on behalf of any Defendant, including, but not limited to, such reserve funds held by

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a payment processor, credit card processor, or bank.

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2. “Defendants” means (a) each Tucker Defendant and (b) each Relief Defendant.

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Furthermore, any person insofar as he or she is acting in the capacity of an officer, agent,

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servant, employee, or attorney of any Tucker Defendant or any Relief Defendant, and any

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person or entity in active concert or participation with any of the foregoing who receives actual

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notice of this Order by personal service or otherwise, is bound to comply with this Order, see

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Fed.R.Civ.P. 65(d), whether these persons or entities are acting directly or through a trust,

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corporation, subsidiary, division, or other device.

14

3. “Document” is synonymous in meaning and equal in scope to the usage of the term

15

in the Federal Rules of Civil Procedure 34(a), and includes writing, drawings, graphs, charts,

16

Internet sites, Web pages, Web sites, electronic correspondence, including email and instant

17

messages, photographs, audio and video recordings, contracts, accounting data, advertisements

18

(including, but not limited to, advertisements placed on the World Wide Web), FTP Logs,

19

Server Access Logs, USENET Newsgroup postings, World Wide Web pages, books, written or

20

printed records, handwritten notes, telephone logs, telephone scripts, receipt books, ledgers,

21

personal and business canceled checks and check registers, bank statements, appointment

22

books, computer records, and other data compilations from which information can be obtained

23

and translated, if necessary, through detection devices into reasonably usable form. A draft or

24

non-identical copy is a separate document within the meaning of the term.

25

Page 12 of 21

4. “Person” means a natural person, organization, or other legal entity, including a

1
2

corporation, partnership, proprietorship, association, cooperative, government or governmental

3

subdivision or agency, or any other group or combination acting as an entity.

4

5. “Plaintiff” or “Commission” or “FTC” means the Federal Trade Commission.

5

6. “Relief Defendants” means Kim Tucker, Park 269, LLC, and their successors,

6

assigns, affiliates, or subsidiaries.
7. “Representatives” means Defendants’ officers, agents, servants, employees, and

7
8

attorneys, and any other person or entity in active concert or participation with them who

9

receives actual notice of this Order by personal service or otherwise.
8. “Tucker Defendants” means Scott A. Tucker, AMG Capital Management, LLC,

10
11

Level 5 Motorsports, LLC, Black Creek Capital Corporation, LeadFlash Consulting LLC,

12

Broadmoor Capital Partners, LLC, and Nereyda M. Tucker, as Executor of the Estate of Blaine

13

A. Tucker, and their successors, entities, assigns, affiliates, or subsidiaries.

14
15

V.

CONCLUSION
IT IS HEREBY ORDERED that the Tucker Defendants’ Motion for Extension of

16

Time (ECF No. 786) and the Relief Defendants’ Motion for Extension of Time (ECF No. 792)

17

are DENIED as moot.

18
19
20

IT IS FURTHER ORDERED that the Tucker Defendants’ Motion to Reconsider (ECF
No. 808) is DENIED.
IT IS FURTHER ORDERED that the FTC’s Motion to Unseal (ECF No. 810) is

21

GRANTED in part and DENIED in part. The Clerk is ordered to UNSEAL the following

22

documents: Declaration of Natalie C. Dempsey (ECF No. 803-8); OneClickCash Traning

23

Manual (ECF No. 803-9); and UCL Team Meeting Minutes (ECF No. 803-10). Blaine

24

Tucker’s Living Trust (ECF No. 803-7) will remain filed under SEAL.

25

Page 13 of 21

1
2

IT IS FURTHER ORDERED that the FTC’s Motion for Preliminary Injunction (ECF
No. 780) is GRANTED pursuant to the following terms:

3

I.

4

ASSET FREEZE

5

IT IS HEREBY ORDERED that Defendants and their Representatives, whether acting

6

directly or through any entity, corporation, subsidiary, division, director, manager, member,

7

affiliate, independent contractor, accountant, financial advisor, or other device, are hereby

8

preliminarily restrained and enjoined from:

9

A.

Transferring, liquidating, converting, encumbering, pledging, loaning, selling,

10

concealing, dissipating, disbursing, assigning, relinquishing, spending, withdrawing, granting a

11

lien or security interest in, or otherwise disposing of any funds, real or personal property,

12

accounts, contracts, shares of stock, lists of consumer names, or other assets, wherever located,

13

including outside the United States, that are:

14

1.

owned or controlled, in whole or in part, by any Defendant;

15

2.

held for the benefit of, directly or indirectly, any Defendant, in whole or in
part;

16
17

3.

in the actual or constructive possession of any Defendant;

18

4.

held by an agent of any Defendant as a retainer for the agent’s provision of
services to Defendants;

19
20

5.

owned or controlled by, or in the actual or constructive possession of or

21

otherwise held for the benefit of, any corporation, partnership, asset

22

protection trust, or other entity that is directly or indirectly owned,

23

managed, controlled by any of the Defendants, or of which any Defendant

24

is an officer, director, member, or manager. This includes, but is not

25

limited to, any assets held by, for, or subject to access by, any of the

Page 14 of 21

1

Defendants at any bank or savings and loan institution, or with any broker-

2

dealer, escrow agent, title company, commodity trading company, precious

3

metal dealer, or other financial institution or depository of any kind; or
6.

4
5

B.

held in any account for which any Defendant is an authorized signer.

Opening or causing to be opened, unless accompanied by counsel for the

6

Commission, any safe deposit boxes titled in the name of any Defendant, either individually or

7

jointly, or subject to access by any Defendant;

8
9
10

C.

Obtaining a personal or secured loan encumbering the assets of any Defendant, or

subject to access by any Defendant;
D.

Incurring liens or other encumbrances on real property, personal property, or

11

other assets in the name, singly or jointly, of any Defendant or of any corporation, partnership,

12

or other entity directly or indirectly owned, managed, or controlled by any Defendant; or

13

E.

Incurring charges or cash advances on any credit or bank card issued in the name,

14

individually or jointly, of any Defendant, or any corporation, partnership, or other entity irectly

15

or indirectly owned, managed, or controlled by any Defendant or of which any Defendant is an

16

officer, director, member, or manager. This includes, but is not limited to, any corporate bank

17

or credit card account for which any Defendant is an authorized signer.

18

IT IS FURTHER ORDERED that the assets affected by this Section shall include

19

assets (a) existing as of the date this Order was entered, or (b) acquired by any Defendant

20

following entry of this Order, if such assets are derived from the conduct alleged in the

21

Commission’s Complaint.

22

IT IS FURTHER ORDERED that Defendant Scott A. Tucker and Relief Defendant

23

Kim Tucker may retain access to $75,000 (collectively) for attorneys’ fees and living expenses

24

for two months following the date of this Order and that Defendant Nereyda M. Tucker may

25

retain $25,000 for attorneys’ fees and living expenses for two months following the date of this

Page 15 of 21

1

Order. After the end of this two-month period, the FTC, Scott A. Tucker, Kim Tucker, and

2

Nereyda M. Tucker shall confer regarding future allowances for attorneys’ fees and living

3

expenses.

4

II.

5

DUTIES OF ASSET HOLDERS

6

IT IS FURTHER ORDERED that any financial or brokerage institution, credit card

7

processing company, payment processor, merchant bank, acquiring bank, business entity, or

8

person who receives actual notice of this Order (by personal service or otherwise) that (a)

9

holds, controls, or maintains custody of any account or asset of any Defendant, (b) holds,

10

controls, or maintains custody of any asset associated with credit or debit card charges made on

11

behalf of any Defendant, including but not limited to, reserve funds held by payment

12

processors, or (c) has held, controlled, or maintained custody of any such account or asset at

13

any time since the date of entry of this Order shall:

14

A.

Hold and retain within its control and prohibit the withdrawal, removal,

15

assignment, transfer, pledge, encumbrance, disbursement, dissipation, relinquishing,

16

conversion, sale, or other disposal of any such asset except by further order of this Court;

17

B.

Deny any person access to any safe deposit box that is:

18

1.

titled in the name of any Defendant, either individually or jointly; or

19

2.

otherwise subject to access by any Defendant;

20
21
22

C.

Provide the FTC’s counsel, within three (3) business days of receiving a copy of

this Order, a sworn statement setting forth:
1.

the identification number of each account or asset:

23

a.

titled in the name, individually or jointly, of any of the Defendants;

24

b.

held on behalf of, or for the benefit of, any of the Defendants; or

25

Page 16 of 21

c.

1

associated with credit or debit card charges made on behalf of any
of the Defendants;

2

2.

3

the balance of each such account, or a description of the nature and value

4

of each such asset as of the close of business on the day on which this

5

Order is served, and, if the account or other asset has been closed or

6

removed, the date closed or removed, the total funds removed in order to

7

close the account, and the name of the person or entity to whom such

8

account or other asset was remitted; and
3.

9

the identification of any safe deposit box that is either titled in the name,

10

individually or jointly, of any of the Defendants, or is otherwise subject to

11

access by any of the Defendants; and

12

D.

Upon the request of the FTC, promptly provide the FTC with copies of all records

13

or other documentation pertaining to such account or asset, including, but not limited to,

14

originals or copies of account applications, account statements, signature cards, checks, drafts,

15

deposit tickets, transfers to and from the accounts, including wire transfers and wire transfer

16

instructions, all other debit and credit instruments or slips, currency transaction reports, 1099

17

forms, and safe deposit box logs.

18

III.

19

FINANCIAL STATEMENTS

20

IT IS FURTHER ORDERED that each Defendant, within five (5) days of service of

21

this Order upon them, shall prepare and deliver to counsel for the Commission completed

22

financial statements on the forms attached to this Order as Attachment A (Financial Statement

23

of Individual Defendant) for themselves individually, and Attachment B (Financial Statement

24

of Corporate Defendant) for each business entity under which they conduct business or of

25

which they are an officer, and for each trust for which any Defendant is a trustee. The financial

Page 17 of 21

1

statements shall be accurate as of the date of entry of this Order. Each Defendant shall include

2

in the financial statements a full accounting of all funds and assets, whether located inside or

3

outside of the United States, that are: (a) titled in the name of such Defendant, jointly,

4

severally, or individually; (b) held by any person or entity for the benefit of such Defendant; or

5

(c) under the direct or indirect control of such Defendant.

6

IV.

7

REPATRIATION OF ASSETS AND DOCUMENTS

8
9
10

IT IS FURTHER ORDERED that within three (3) days following the service of this
Order, each Defendant shall:
A.

Provide the Commission with a full accounting of all funds, documents, and

11

assets outside of the United States which are: (1) titled in the name, individually or jointly, of

12

any Defendant; or (2) held by any person or entity for the benefit of any Defendant; or (3)

13

under the direct or indirect control, whether jointly or singly, of any Defendant; and

14

B.

Transfer to the territory of the United States all funds, documents, and assets

15

located in foreign countries which are: (1) titled in the name individually or jointly of any

16

Defendant; or (2) held by any person or entity, for the benefit of any Defendant; or (3) under

17

the direct or indirect control of any Defendant, whether jointly or singly.

18

V.

19

NONINTERFERENCE WITH REPATRIATION

20

IT IS FURTHER ORDERED that Defendants and their Representatives, whether

21

acting directly or through any entity, corporation, subsidiary, division, director, manager,

22

member, affiliate, independent contractor, accountant, financial advisor, or other device, are

23

hereby restrained and enjoined from taking any action, directly or indirectly, which may result

24

in the encumbrance or dissipation of foreign assets, or in the hindrance of the repatriation

25

required by Section IV of this Order, including, but not limited to:

Page 18 of 21

1

A.

Sending any statement, letter, fax, e-mail or wire transmission, or telephoning or

2

engaging in any other act, directly or indirectly, that results in a determination by a foreign

3

trustee or other entity that a “duress” event has occurred under the terms of a foreign trust

4

agreement until such time that all assets have been fully repatriated pursuant to Section IV of

5

this Order; or

6

B.

Notifying any trustee, protector or other agent of any foreign trust or other related

7

entities of either the existence of this Order, or of the fact that repatriation is required pursuant

8

to a court order, until such time that all assets have been fully repatriated pursuant to Section IV

9

of this Order.

10

VI.

11

ACKNOWLEDGEMENT AND DISTRIBUTION OF ORDER BY DEFENDANTS

12
13
14
15
16

IT IS FURTHER ORDERED that Defendants obtain acknowledgments of receipt of
this Order:
A.

Each Defendant, within three (3) days of entry of this Order, must submit to the

Commission an acknowledgment of receipt of this Order sworn under penalty of perjury.
B.

Defendants shall immediately provide a copy of this Order to each officer,

17

director, employee, agent, attorney, or other representative of any Defendant, who has the

18

ability to dispose of or manage the Assets of any Defendant. Defendants shall, within ten (10)

19

days from the date of entry of this Order, provide the FTC with a sworn statement that

20

Defendants have complied with this provision of the Order, which statement shall include the

21

names and addresses of each such person or entity who received a copy of this Order.

22

Furthermore, Defendants shall not take any action that would encourage those who receive this

23

Order to disregard it or believe that they are not bound by its provisions.

24
25

Page 19 of 21

1

VII.

2

SERVICE ON FINANCIAL INSTITUTIONS,

3

ENTITIES, OR PERSONS

4

IT IS FURTHER ORDERED that copies of this Order may be served by any means,

5

including facsimile transmission, e-mail, and overnight delivery service, upon any financial

6

institution or other entity or person that may have possession, custody, or control of any

7

documents or assets of any Defendant, or that may otherwise be subject to any provision of this

8

Order. Service upon any branch or office of any financial institution shall effect service upon

9

the entire financial institution.

10

VIII.

11

GENERAL SERVICE OF ORDER

12

IT IS FURTHER ORDERED that pursuant to Rule 4(c)(2), Fed. R. Civ. P., this Order

13

and the initial papers filed in this matter may be served on Defendants, upon the business

14

premises of Defendants, and upon any financial institution or other entity or person that may

15

have possession, custody or control of any documents or assets of any Defendant, or that may

16

be subject to any provision of this Order, by employees of the FTC, by employees of any other

17

law enforcement agency, by any agent of Plaintiff, or by any agent of any process service

18

retained by Plaintiff.

19

IX.

20

CORRESPONDENCE

21
22
23
24
25

IT IS FURTHER ORDERED that, for the purpose of this Order, all correspondence
and service of pleadings on Plaintiff shall be addressed to:
Nikhil Singhvi
Jason D. Schall
Ioana Rusu
Federal Trade Commission
600 Pennsylvania Avenue NW, CC-10232
Page 20 of 21

Washington, DC 20580
FAX: [phone]
Email: [e-mail], [e-mail], [e-mail]

1
2
3

X.

4

RETENTION OF JURISDICTION

5
6

IT IS FURTHER ORDERED that this Court shall retain jurisdiction of this matter for
all purposes.

7
8
9
10

31
DATED this _____ day of March, 2016.

11
12
13

___________________________________
Gloria M. Navarro, Chief Judge
United States District Judge

14
15
16
17
18
19
20
21
22
23
24
25

Page 21 of 21

Attachment A

FEDERAL TRADE COMMISSION
FINANCIAL STATEMENT OF INDIVIDUAL DEFENDANT

Definitions and Instructions:
1. Complete all items. Enter “None” or “N/A” (“Not Applicable”) in the first field only of any item that does not apply
to you. If you cannot fully answer a question, explain why.
2. “Dependents” include your spouse, live-in companion, dependent children, or any other person, whom you or your
spouse (or your children’s other parent) claimed or could have claimed as a dependent for tax purposes at any
time during the past five years.
3. “Assets” and “Liabilities” include ALL assets and liabilities, located within the United States or any foreign country
or territory, whether held individually or jointly and whether held by you, your spouse, or your dependents, or held
by others for the benefit of you, your spouse, or your dependents.
4. Attach continuation pages as needed. On the financial statement, state next to the Item number that the Item is
being continued. On the continuation page(s), identify the Item number(s) being continued.
5. Type or print legibly.
6. Initial each page in the space provided in the lower right corner.
7. Sign and date the completed financial statement on the last page.

Penalty for False Information:
Federal law provides that any person may be imprisoned for not more than five years, fined, or both, if such person:
(1) “in any matter within the jurisdiction of the executive, legislative, or judicial branch of the Government of the
United States, knowingly and willfully falsifies, conceals or covers up by any trick, scheme, or devise a material fact;
makes any materially false, fictitious or fraudulent statement or representation; or makes or uses any false writing or
document knowing the same to contain any materially false, fictitious or fraudulent statement or entry” (18 U.S.C. § 1001);
(2) “in any . . . statement under penalty of perjury as permitted under section 1746 of title 28, United States Code,
willfully subscribes as true any material matter which he does not believe to be true” (18 U.S.C. § 1621); or
(3) “in any ( . . . statement under penalty of perjury as permitted under section 1746 of title 28, United States
Code) in any proceeding before or ancillary to any court or grand jury of the United States knowingly makes any false
material declaration or makes or uses any other information . . . knowing the same to contain any false material
declaration” (18 U.S.C. § 1623).
For a felony conviction under the provisions cited above, federal law provides that the fine may be not more than the
greater of (i) $250,000 for an individual or $500,000 for a corporation, or (ii) if the felony results in pecuniary gain to any
person or pecuniary loss to any person other than the defendant, the greater of twice the gross gain or twice the gross
loss. 18 U.S.C. § 3571.

Federal Trade Commission Financial Statement of Individual Defendant

BACKGROUND INFORMATION
Item 1. Information About You
Full Name

Social Security No.

Current Address of Primary Residence

Driver’s License No.

State Issued

Phone Numbers
Home: (
)
Fax: (
)
Rent

Own

From (Date):

Date of Birth:

/
/
(mm/dd/yyyy)
Place of Birth

E-Mail Address

/
/
(mm/dd/yyyy)

Internet Home Page

Previous Addresses for past five years (if required, use additional pages at end of form)
Address

From:

/
/
(mm/dd/yyyy)

Rent
Address

From:

From:

Rent

/
/
(mm/dd/yyyy)

Own

/

Rent
Address

Until:

/

Until:

/

/

Until:

/

/

Own

/

/

Own

Identify any other name(s) and/or social security number(s) you have used, and the time period(s) during which they
were used:

Item 2. Information About Your Spouse or Live-In Companion
Spouse/Companion's Name

Social Security No.

Address (if different from yours)

Phone Number

(

Date of Birth
/
/
(mm/dd/yyyy)
Place of Birth

)
Rent

/
/
(mm/dd/yyyy)
Identify any other name(s) and/or social security number(s) you have used, and the time period(s) during which they were used:

Employer’s Name and Address

Own

From (Date):

Job Title
Years in Present Job

Annual Gross Salary/Wages
$

Item 3. Information About Your Previous Spouse
Name and Address

Social Security No.
Date of Birth
/
/
(mm/dd/yyyy)

Item 4. Contact Information (name and address of closest living relative other than your spouse)
Name and Address

Phone Number

(

)

Initials:
1 of 10

Federal Trade Commission Financial Statement of Individual Defendant

Item 5. Information About Dependents (whether or not they reside with you)
Name and Address

Social Security No.

Date of Birth
/
/
(mm/dd/yyyy)

Relationship
Name and Address

Social Security No.

Date of Birth
/
/
(mm/dd/yyyy)

Relationship
Name and Address

Date of Birth
/
/
(mm/dd/yyyy)

Social Security No.
Relationship

Name and Address

Date of Birth
/
/
(mm/dd/yyyy)

Social Security No.
Relationship

Item 6. Employment Information/Employment Income
Provide the following information for this year-to-date and for each of the previous five full years, for each business entity of which you were a director,
officer, member, partner, employee (including self-employment), agent, owner, shareholder, contractor, participant or consultant at any time during that
period. “Income” includes, but is not limited to, any salary, commissions, distributions, draws, consulting fees, loans, loan payments, dividends,
royalties, and benefits for which you did not pay (e.g., health insurance premiums, automobile lease or loan payments) received by you or anyone else
on your behalf.
Company Name and Address

Dates Employed

Income Received: Y-T-D & 5 Prior Yrs.
Year

From (Month/Year)
/
Ownership Interest?

From (Month/Year)
/

Yes

To (Month/Year)
/

Income

20

$
$

To (Month/Year)
/

No

Positions Held

$
$

/

/

$

/

/

$

Company Name and Address

Dates Employed

Income Received: Y-T-D & 5 Prior Yrs.
Year

From (Month/Year)
/
Ownership Interest?

From (Month/Year)
/

Yes

To (Month/Year)
/

Income

20

$
$

To (Month/Year)
/

No

Positions Held

$
$

/

/

$

/

/

$

Company Name and Address

Dates Employed

Income Received: Y-T-D & 5 Prior Yrs.
Year

From (Month/Year)
/
Ownership Interest?
Positions Held

Yes

To (Month/Year)
/

From (Month/Year)
/

To (Month/Year)
/

No

Income

20

$
$
$
$

/

/

$

/

/

$

Initials:
2 of 10

Federal Trade Commission Financial Statement of Individual Defendant

Item 7. Pending Lawsuits Filed By or Against You or Your Spouse
List all pending lawsuits that have been filed by or against you or your spouse in any court or before an administrative agency in the United States or in
any foreign country or territory. Note: At Item 12, list lawsuits that resulted in final judgments or settlements in your favor. At Item 21, list lawsuits that
resulted in final judgments or settlements against you.
Nature of
Status or
Caption of Proceeding
Court or Agency and Location
Case No.
Relief Requested
Proceeding
Disposition

Item 8. Safe Deposit Boxes
List all safe deposit boxes, located within the United States or in any foreign country or territory, whether held individually or jointly and whether held by
you, your spouse, or any of your dependents, or held by others for the benefit of you, your spouse, or any of your dependents.
Name of Owner(s)

Name & Address of Depository Institution

Box No.

Contents

Initials:
3 of 10

Federal Trade Commission Financial Statement of Individual Defendant

FINANCIAL INFORMATION
REMINDER: When an item asks for information regarding your “assets” and “liabilities” include ALL assets and liabilities, located within
the United States or in any foreign country or territory, or institution, whether held individually or jointly, and whether held by you, your
spouse, or any of your dependents, or held by others for the benefit of you, your spouse, or any of your dependents. In addition, provide
all documents requested in Item 24 with your completed Financial Statement.

ASSETS
Item 9. Cash, Bank, and Money Market Accounts
List cash on hand (as opposed to cash in bank accounts or other financial accounts) and all bank accounts, money market accounts, or other financial
accounts, including but not limited to checking accounts, savings accounts, and certificates of deposit. The term “cash on hand” includes but is not
limited to cash in the form of currency, uncashed checks, and money orders.
a. Amount of Cash on Hand $
b. Name on Account

Form of Cash on Hand
Name & Address of Financial Institution

Account No.

Current Balance
$

$

$

$

$

Item 10. Publicly Traded Securities
List all publicly traded securities, including but not limited to, stocks, stock options, corporate bonds, mutual funds, U.S. government securities (including
but not limited to treasury bills and treasury notes), and state and municipal bonds. Also list any U.S. savings bonds.
Owner of Security

Issuer

Broker House, Address

Broker Account No.
Current Fair Market Value
$

Owner of Security

Issuer

Broker House, Address

Type of Security

No. of Units Owned

Loan(s) Against Security
$

Broker Account No.
Current Fair Market Value
$

Owner of Security

Issuer

Broker House, Address

Type of Security

No. of Units Owned

Loan(s) Against Security
$

Broker Account No.
Current Fair Market Value
$

Type of Security

No. of Units Owned

Loan(s) Against Security
$

Initials:
4 of 10

Federal Trade Commission Financial Statement of Individual Defendant

Item 11. Non-Public Business and Financial Interests
List all non-public business and financial interests, including but not limited to any interest in a non-public corporation, subchapter-S corporation, limited
liability corporation (“LLC”), general or limited partnership, joint venture, sole proprietorship, international business corporation or personal investment
corporation, and oil or mineral lease.
Entity’s Name & Address

Type of Business or Financial
Interest (e.g., LLC, partnership)

Owner
(e.g., self, spouse)

Ownership
%

If Officer, Director, Member
or Partner, Exact Title

Item 12. Amounts Owed to You, Your Spouse, or Your Dependents
Debtor’s Name & Address

Date Obligation
Incurred (Month/Year)
/
Current Amount Owed
$

Original Amount Owed
$

Nature of Obligation (if the result of a final court
judgment or settlement, provide court name
and docket number)

Payment Schedule
$

Debtor’s Telephone

Debtor’s Relationship to You

Debtor’s Name & Address

Date Obligation
Incurred (Month/Year)
/
Current Amount Owed
$

Debtor’s Telephone

Original Amount Owed
$

Nature of Obligation (if the result of a final court
judgment or settlement, provide court name
and docket number)

Payment Schedule
$

Debtor’s Relationship to You

Item 13. Life Insurance Policies
List all life insurance policies (including endowment policies) with any cash surrender value.
Insurance Company’s Name, Address, & Telephone No.
Beneficiary

Policy No.

Insured

Beneficiary

Policy No.

Insured

Insurance Company’s Name, Address, & Telephone No.

Loans Against Policy
$

Loans Against Policy
$

Face Value
$
Surrender Value
$
Face Value
$
Surrender Value
$

Item 14. Deferred Income Arrangements
List all deferred income arrangements, including but not limited to, deferred annuities, pensions plans, profit-sharing plans, 401(k) plans, IRAs, Keoghs,
other retirement accounts, and college savings plans (e.g., 529 Plans).
Trustee or Administrator’s Name, Address & Telephone No.

Name on Account
Date Established
/
/
(mm/dd/yyyy)

Trustee or Administrator’s Name, Address & Telephone No.

Account No.
Type of Plan

Surrender Value before
Taxes and Penalties
$
Account No.

Type of Plan

Surrender Value before
Taxes and Penalties
$

Name on Account
Date Established
/
/

Initials:
5 of 10

Federal Trade Commission Financial Statement of Individual Defendant

Item 15. Pending Insurance Payments or Inheritances
List any pending insurance payments or inheritances owed to you.
Type

Amount Expected

Date Expected (mm/dd/yyyy)

$

/

/

$

/

/

$

/

/

Item 16. Vehicles
List all cars, trucks, motorcycles, boats, airplanes, and other vehicles.
Vehicle Type
Make

Registration State & No.

Purchase Price
$
Account/Loan No.

Model

Address of Vehicle’s Location

Lender’s Name and Address

Registered Owner’s Name

Vehicle Type

Year

Make

Registration State & No.

Purchase Price
$
Account/Loan No.

Model

Address of Vehicle’s Location

Registered Owner’s Name

Original Loan Amount
$
Current Value
$

Current Balance
$
Monthly Payment
$

Original Loan Amount
$
Current Value
$

Current Balance
$
Monthly Payment
$

Lender’s Name and Address

Vehicle Type

Year

Registered Owner’s Name

Make

Registration State & No.

Purchase Price
$
Account/Loan No.

Model

Address of Vehicle’s Location

Lender’s Name and Address

Registered Owner’s Name

Vehicle Type

Year

Year

Make

Registration State & No.

Purchase Price
$
Account/Loan No.

Model

Address of Vehicle’s Location

Original Loan Amount
$
Current Value
$

Current Balance
$
Monthly Payment
$

Original Loan Amount
$
Current Value
$

Current Balance
$
Monthly Payment
$

Lender’s Name and Address

Item 17. Other Personal Property
List all other personal property not listed in Items 9-16 by category, whether held for personal use, investment or any other reason, including but not
limited to coins, stamps, artwork, gemstones, jewelry, bullion, other collectibles, copyrights, patents, and other intellectual property.
Property Category
(e.g., artwork, jewelry)

Name of Owner

Property Location

Acquisition Cost

Current Value

$

$

$

$

$

$

Initials:
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Federal Trade Commission Financial Statement of Individual Defendant

Item 18. Real Property
List all real property interests (including any land contract)
Property’s Location

Type of Property

Acquisition Date (mm/dd/yyyy)
/
/
Lender’s Name and Address

Purchase Price
$

Name(s) on Title or Contract and Ownership Percentages

Current Value
$
Loan or Account No.

Other Mortgage Loan(s) (describe)

Property’s Location

Purchase Price
$

Current Balance On First Mortgage or
Contract
$
Monthly Payment
$
Rental Unit

Monthly Payment
$
Monthly Rent Received
Current Balance
$
$
Name(s) on Title or Contract and Ownership Percentages

Type of Property

Acquisition Date (mm/dd/yyyy)
/
/
Lender’s Name and Address

Basis of Valuation

Current Value
$
Loan or Account No.

Other Mortgage Loan(s) (describe)

Basis of Valuation
Current Balance On First Mortgage or
Contract
$
Monthly Payment
$
Rental Unit

Monthly Payment
$
Current Balance
$

Monthly Rent Received
$

LIABILITIES
Item 19. Credit Cards
List each credit card account held by you, your spouse, or your dependents, and any other credit cards that you, your spouse, or your dependents use,
whether issued by a United States or foreign financial institution.
Name of Credit Card (e.g., Visa,
MasterCard, Department Store)

Account No.

Name(s) on Account

Current Balance
$
$
$
$
$

Item 20. Taxes Payable
List all taxes, such as income taxes or real estate taxes, owed by you, your spouse, or your dependents.
Type of Tax

Amount Owed

Year Incurred

$
$
$

Initials:
7 of 10

Federal Trade Commission Financial Statement of Individual Defendant

Item 21. Other Amounts Owed by You, Your Spouse, or Your Dependents
List all other amounts, not listed elsewhere in this financial statement, owed by you, your spouse, or your dependents.
Lender/Creditor’s Name, Address, and Telephone No.

Nature of Debt (if the result of a court judgment or settlement, provide court name and docket
number)

Lender/Creditor’s Relationship to You

Date Liability Was Incurred
Original Amount Owed
Current Amount Owed
Payment Schedule
/
/
$
$
(mm/dd/yyyy)
Lender/Creditor’s Name, Address, and Telephone No. Nature of Debt (if the result of a court judgment or settlement, provide court name and docket
number)

Lender/Creditor’s Relationship to You

Date Liability Was Incurred
/
/
(mm/dd/yyyy)

Original Amount Owed
$

Current Amount Owed
$

Payment Schedule

OTHER FINANCIAL INFORMATION
Item 22. Trusts and Escrows
List all funds and other assets that are being held in trust or escrow by any person or entity for you, your spouse, or your dependents. Include any legal
retainers being held on your behalf by legal counsel. Also list all funds or other assets that are being held in trust or escrow by you, your spouse, or your
dependents, for any person or entity.
Trustee or Escrow Agent’s Name & Address

Date Established
(mm/dd/yyyy)
/
/

Grantor

Beneficiaries

Present Market Value of Assets*
$

/

/

$

/

/

$

*If the market value of any asset is unknown, describe the asset and state its cost, if you know it.

Item 23. Transfers of Assets
List each person or entity to whom you have transferred, in the aggregate, more than $5,000 in funds or other assets during the previous five years by
loan, gift, sale, or other transfer (exclude ordinary and necessary living and business expenses paid to unrelated third parties). For each such person or
entity, state the total amount transferred during that period.
Transferee’s Name, Address, & Relationship

Property Transferred

Aggregate Value*

Transfer Date
(mm/dd/yyyy)

$

/

/

$

/

/

$

/

Type of Transfer
(e.g., Loan, Gift)

/

*If the market value of any asset is unknown, describe the asset and state its cost, if you know it.

Initials:
8 of 10

Federal Trade Commission Financial Statement of Individual Defendant

Item 24. Document Requests
Provide copies of the following documents with your completed Financial Statement.

Federal tax returns filed during the last three years by or on behalf of you, your spouse, or your dependents.
All applications for bank loans or other extensions of credit (other than credit cards) that you, your spouse, or your
dependents have submitted within the last two years, including by obtaining copies from lenders if necessary.
Item 9

For each bank account listed in Item 9, all account statements for the past 3 years.

Item 11

For each business entity listed in Item 11, provide (including by causing to be generated from accounting records) the
most recent balance sheet, tax return, annual income statement, the most recent year-to-date income statement, and all
general ledger files from account records.

Item 17

All appraisals that have been prepared for any property listed in Item 17, including appraisals done for insurance
purposes. You may exclude any category of property where the total appraised value of all property in that category is
less than $2,000.

Item 18

All appraisals that have been prepared for real property listed in Item 18.

Item 21

Documentation for all debts listed in Item 21.

Item 22

All executed documents for any trust or escrow listed in Item 22. Also provide any appraisals, including insurance
appraisals that have been done for any assets held by any such trust or in any such escrow.

SUMMARY FINANCIAL SCHEDULES
Item 25. Combined Balance Sheet for You, Your Spouse, and Your Dependents
Assets

Liabilities

Cash on Hand (Item 9)
Funds Held in Financial Institutions (Item 9)
U.S. Government Securities (Item 10)
Publicly Traded Securities (Item 10)
Non-Public Business and Financial Interests (Item 11)
Amounts Owed to You (Item 12)
Life Insurance Policies (Item 13)
Deferred Income Arrangements (Item 14)
Vehicles (Item 16)
Other Personal Property (Item 17)
Real Property (Item 18)
Other Assets (Itemize)

$
$
$
$
$
$
$
$
$
$
$
$
$
$
$

Total Assets

Loans Against Publicly Traded Securities (Item 10)
Vehicles - Liens (Item 16)
Real Property – Encumbrances (Item 18)
Credit Cards (Item 19)
Taxes Payable (Item 20)
Amounts Owed by You (Item 21)
Other Liabilities (Itemize)

Total Liabilities

$
$
$
$
$
$
$
$
$
$
$
$
$
$
$

Item 26. Combined Current Monthly Income and Expenses for You, Your Spouse, and Your Dependents
Provide the current monthly income and expenses for you, your spouse, and your dependents. Do not include credit card payments separately; rather,
include credit card expenditures in the appropriate categories.
Income (State source of each item)
Salary - After Taxes
Source:
Fees, Commissions, and Royalties
Source:
Interest
Source:
Dividends and Capital Gains
Source:
Gross Rental Income
Source:
Profits from Sole Proprietorships
Source:
Distributions from Partnerships, S-Corporations,
and LLCs
Source:

$
$
$
$
$
$

Expenses
Mortgage or Rental Payments for Residence(s)
Property Taxes for Residence(s)
Rental Property Expenses, Including Mortgage Payments, Taxes,
and Insurance
Car or Other Vehicle Lease or Loan Payments
Food Expenses
Clothing Expenses

$
$
$
$
$
$

Utilities
$

$

Initials:
9 of 10

Federal Trade Commission Financial Statement of Individual Defendant

Item 26. Combined Current Monthly Income and Expenses for You, Your Spouse, and Your Dependents (cont.)
Distributions from Trusts and Estates
Source:
Distributions from Deferred Income Arrangements
Source:
Social Security Payments
Alimony/Child Support Received
Gambling Income

$
$
$
$
$

Medical Expenses, Including Insurance
Other Insurance Premiums
Other Transportation Expenses

$
$
$
$
$
$

$
$
$
$

$

Other Expenses (Itemize)

Other Income (Itemize)

Total Income

$

Total Expenses

$

ATTACHMENTS
Item 27. Documents Attached to this Financial Statement
List all documents that are being submitted with this financial statement. For any Item 24 documents that are not attached, explain why.
Item No. Document Relates To

Description of Document

I am submitting this financial statement with the understanding that it may affect action by the Federal Trade
Commission or a federal court. I have used my best efforts to obtain the information requested in this statement. The
responses I have provided to the items above are true and contain all the requested facts and information of which I have
notice or knowledge. I have provided all requested documents in my custody, possession, or control. I know of the
penalties for false statements under 18 U.S.C. § 1001, 18 U.S.C. § 1621, and 18 U.S.C. § 1623 (five years imprisonment
and/or fines). I certify under penalty of perjury under the laws of the United States that the foregoing is true and correct.

Executed on:
_______________
(Date)

___________________________________
Signature

10 of 10

Federal Trade Commission Financial Statement of Individual Defendant

Attachment B

FEDERAL TRADE COMMISSION
FINANCIAL STATEMENT OF CORPORATE DEFENDANT

Instructions:
1.

Complete all items. Enter “None” or "N/A" (“Not Applicable”) where appropriate. If you cannot fully answer a
question, explain why.

2.

The font size within each field will adjust automatically as you type to accommodate longer responses.

3.

In completing this financial statement, “the corporation” refers not only to this corporation but also to each of its
predecessors that are not named defendants in this action.

4.

When an Item asks for information about assets or liabilities “held by the corporation,” include ALL such assets
and liabilities, located within the United States or elsewhere, held by the corporation or held by others for the
benefit of the corporation.

5.

Attach continuation pages as needed. On the financial statement, state next to the Item number that the Item is
being continued. On the continuation page(s), identify the Item number being continued.

6.

Type or print legibly.

7.

An officer of the corporation must sign and date the completed financial statement on the last page and initial
each page in the space provided in the lower right corner.

Penalty for False Information:
Federal law provides that any person may be imprisoned for not more than five years, fined, or both, if such person:
(1) “in any matter within the jurisdiction of any department or agency of the United States knowingly and
willfully falsifies, conceals or covers up by any trick, scheme, or device a material fact, or makes any false,
fictitious or fraudulent statements or representations, or makes or uses any false writing or document knowing the
same to contain any false, fictitious or fraudulent statement or entry” (18 U.S.C. § 1001);
(2) “in any . . . statement under penalty of perjury as permitted under section 1746 of title 28, United States Code,
willfully subscribes as true any material matter which he does not believe to be true” (18 U.S.C. § 1621); or
(3) “in any (. . . statement under penalty of perjury as permitted under section 1746 of title 28, United States
Code) in any proceeding before or ancillary to any court or grand jury of the United States knowingly makes any
false material declaration or makes or uses any other information . . . knowing the same to contain any false
material declaration.” (18 U.S.C. § 1623)
For a felony conviction under the provisions cited above, federal law provides that the fine may be not more than the
greater of (i) $250,000 for an individual or $500,000 for a corporation, or (ii) if the felony results in pecuniary gain to any
person or pecuniary loss to any person other than the defendant, the greater of twice the gross gain or twice the gross loss.
18 U.S.C. § 3571.

BACKGROUND INFORMATION

Item 1.

General Information

Corporation’s Full Name ___________________________________________________________________________
Primary Business Address ______________________________________________________ From (Date) _________
Telephone No. _____________________________ Fax No. _____________________________
E-Mail Address________________________ Internet Home Page________________________
All other current addresses & previous addresses for past five years, including post office boxes and mail drops:
Address____________________________________________________________ From/Until____________________
Address____________________________________________________________ From/Until____________________
Address____________________________________________________________ From/Until____________________
All predecessor companies for past five years:
Name & Address _________________________________________________________ From/Until ______________
Name & Address _________________________________________________________ From/Until ______________
Name & Address _________________________________________________________ From/Until ______________

Item 2.

Legal Information

Federal Taxpayer ID No. _________________________ State & Date of Incorporation _________________________
State Tax ID No. ____________________ State ________________ Profit or Not For Profit _____________________
Corporation’s Present Status: Active ________________ Inactive _______________ Dissolved __________________
If Dissolved: Date dissolved _________________________ By Whom ______________________________________
Reasons _________________________________________________________________________________________
Fiscal Year-End (Mo./Day) ________________ Corporation’s Business Activities _____________________________

Item 3.

Registered Agent

Name of Registered Agent __________________________________________________________________________
Address __________________________________________________________ Telephone No. __________________

Page 2

Initials __________

Item 4.

Principal Stockholders

List all persons and entities that own at least 5% of the corporation’s stock.
% Owned

Name & Address

_________________________________________________________________________________ ______________
_________________________________________________________________________________ ______________
_________________________________________________________________________________ ______________
_________________________________________________________________________________ ______________

Item 5.

Board Members

List all members of the corporation’s Board of Directors.
Name & Address

% Owned

Term (From/Until)

____________________________________________________________________ __________ _________________
____________________________________________________________________ __________ _________________
____________________________________________________________________ __________ _________________
____________________________________________________________________ __________ _________________
____________________________________________________________________ __________ _________________

Item 6.

Officers

List all of the corporation’s officers, including de facto officers (individuals with significant management responsibility
whose titles do not reflect the nature of their positions).
Name & Address

% Owned

_______________________________________________________________________________ ________________
_______________________________________________________________________________ ________________
_______________________________________________________________________________ ________________
_______________________________________________________________________________ ________________
_______________________________________________________________________________ ________________

Page 3

Initials __________

Item 7.

Businesses Related to the Corporation

List all corporations, partnerships, and other business entities in which this corporation has an ownership interest.
Name & Address

Business Activities

% Owned

___________________________________________________________________ ___________________ _________
___________________________________________________________________ ___________________ _________
___________________________________________________________________ ___________________ _________
State which of these businesses, if any, has ever transacted business with the corporation _______________________
________________________________________________________________________________________________

Item 8.

Businesses Related to Individuals

List all corporations, partnerships, and other business entities in which the corporation’s principal stockholders, board
members, or officers (i.e., the individuals listed in Items 4 - 6 above) have an ownership interest.
Business Name & Address

Individual’s Name

Business Activities

% Owned

__________________ __________________________________________________ __________________ ________
__________________ __________________________________________________ __________________ ________
__________________ __________________________________________________ __________________ ________
State which of these businesses, if any, have ever transacted business with the corporation _______________________
________________________________________________________________________________________________

Item 9.

Related Individuals

List all related individuals with whom the corporation has had any business transactions during the three previous fiscal
years and current fiscal year-to-date. A “related individual” is a spouse, sibling, parent, or child of the principal
stockholders, board members, and officers (i.e., the individuals listed in Items 4 - 6 above).
Name and Address

Relationship

Business Activities

_________________________________________________________ _________________ ______________________
_________________________________________________________ _________________ ______________________
_________________________________________________________ _________________ ______________________

Page 4

Initials __________

Item 10.

Outside Accountants

List all outside accountants retained by the corporation during the last three years.
Firm Name

Name

Address

CPA/PA?

____________________ ______________________ ________________________________________ ____________
____________________ ______________________ ________________________________________ ____________
____________________ ______________________ ________________________________________ ____________
____________________ ______________________ ________________________________________ ____________
____________________ ______________________ ________________________________________ ____________

Item 11.

Corporation’s Recordkeeping

List all individuals within the corporation with responsibility for keeping the corporation’s financial books and records for
the last three years.
Position(s) Held

Name, Address, & Telephone Number

____________________________________________________________________________ ___________________
____________________________________________________________________________ ___________________
____________________________________________________________________________ ___________________
____________________________________________________________________________ ___________________

Item 12.

Attorneys

List all attorneys retained by the corporation during the last three years.
Name

Firm Name

Address

____________________ ___________________________ ________________________________________________
____________________ ___________________________ ________________________________________________
____________________ ___________________________ ________________________________________________
____________________ ___________________________ ________________________________________________
____________________ ___________________________ ________________________________________________

Page 5

Initials __________

Item 13.

Pending Lawsuits Filed by the Corporation

List all pending lawsuits that have been filed by the corporation in court or before an administrative agency. (List
lawsuits that resulted in final judgments or settlements in favor of the corporation in Item 25).
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________

Page 6

Initials __________

Item 14.

Current Lawsuits Filed Against the Corporation

List all pending lawsuits that have been filed against the corporation in court or before an administrative agency. (List
lawsuits that resulted in final judgments, settlements, or orders in Items 26 - 27).
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address___________________________________________________________________________
Docket No._________________ Relief Requested____________________ Nature of Lawsuit____________________
____________________________________ Status______________________________________________________

Page 7

Initials __________

Item 15.

Bankruptcy Information

List all state insolvency and federal bankruptcy proceedings involving the corporation.
Commencement Date _________________ Termination Date _________________ Docket No. __________________
If State Court: Court & County _______________________ If Federal Court: District __________________________
Disposition ______________________________________________________________________________________

Item 16.

Safe Deposit Boxes

List all safe deposit boxes, located within the United States or elsewhere, held by the corporation, or held by others for the
benefit of the corporation. On a separate page, describe the contents of each box.
Owner’s Name

Name & Address of Depository Institution

Box No.

__________________ ___________________________________________________________________ __________
__________________ ___________________________________________________________________ __________
__________________ ___________________________________________________________________ __________
__________________ ___________________________________________________________________ __________
__________________ ___________________________________________________________________ __________

FINANCIAL INFORMATION
REMINDER: When an Item asks for information about assets or liabilities “held by the corporation,” include
ALL such assets and liabilities, located within the United States or elsewhere, held by the corporation or held by
others for the benefit of the corporation.
Item 17.

Tax Returns

List all federal and state corporate tax returns filed for the last three complete fiscal years. Attach copies of all returns.
Federal/
State/Both

Tax Year

Tax Due
Federal

Tax Paid
Federal

Tax Due
State

Tax Paid
State

Preparer’s Name

___________ __________ $_________ $_________ $__________ $__________ ______________________________
___________ __________ $_________ $_________ $__________ $__________ ______________________________
___________ __________ $_________ $_________ $__________ $__________ ______________________________

Page 8

Initials __________

Item 18.

Financial Statements

List all financial statements that were prepared for the corporation’s last three complete fiscal years and for the current
fiscal year-to-date. Attach copies of all statements, providing audited statements if available.
Year

Balance Sheet

Profit & Loss Statement

Cash Flow Statement Changes in Owner’s Equity Audited?

_________ _____________ ______________________ __________________ _______________________ ________
_________ _____________ ______________________ __________________ _______________________ ________
_________ _____________ ______________________ __________________ _______________________ ________
_________ _____________ ______________________ __________________ _______________________ ________
Item 19.

Financial Summary

For each of the last three complete fiscal years and for the current fiscal year-to-date for which the corporation has not
provided a profit and loss statement in accordance with Item 18 above, provide the following summary financial
information.
Current Year-to-Date

1 Year Ago

2 Years Ago

3 Years Ago

Gross Revenue

$_________________

$_______________

$_______________

$_______________

Expenses

$_________________

$_______________

$_______________

$_______________

Net Profit After Taxes

$_________________

$_______________

$_______________

$_______________

Payables

$_________________

Receivables

$_________________

Item 20.

Cash, Bank, and Money Market Accounts

List cash and all bank and money market accounts, including but not limited to, checking accounts, savings accounts, and
certificates of deposit, held by the corporation. The term “cash” includes currency and uncashed checks.
Cash on Hand $_________________________ Cash Held for the Corporation’s Benefit $_______________________
Current
Balance
_____________________________________ _______________________________ ______________ $___________
Name & Address of Financial Institution

Signator(s) on Account

Account No.

_____________________________________ _______________________________ ______________ $___________
_____________________________________ _______________________________ ______________ $___________
_____________________________________ _______________________________ ______________ $___________

Page 9

Initials __________

Item 21.

Government Obligations and Publicly Traded Securities

List all U.S. Government obligations, including but not limited to, savings bonds, treasury bills, or treasury notes, held by
the corporation. Also list all publicly traded securities, including but not limited to, stocks, stock options, registered and
bearer bonds, state and municipal bonds, and mutual funds, held by the corporation.
Issuer _________________________________ Type of Security/Obligation __________________________________
No. of Units Owned __________ Current Fair Market Value $__________________ Maturity Date _______________
Issuer _________________________________ Type of Security/Obligation __________________________________
No. of Units Owned __________ Current Fair Market Value $__________________ Maturity Date _______________

Item 22.

Real Estate

List all real estate, including leaseholds in excess of five years, held by the corporation.
Type of Property________________________________ Property’s Location__________________________________
Name(s) on Title and Ownership Percentages___________________________________________________________
Current Value $____________________ Loan or Account No. __________________________
Lender’s Name and Address_________________________________________________________________________
Current Balance On First Mortgage $_______________ Monthly Payment $______________
Other Loan(s) (describe)____________________________________________ Current Balance $_________________
Monthly Payment $__________________ Rental Unit?_________________ Monthly Rent Received $_____________

Type of Property________________________________ Property’s Location__________________________________
Name(s) on Title and Ownership Percentages___________________________________________________________
Current Value $____________________ Loan or Account No. __________________________
Lender’s Name and Address_________________________________________________________________________
Current Balance On First Mortgage $_______________ Monthly Payment $______________
Other Loan(s) (describe)____________________________________________ Current Balance $_________________
Monthly Payment $__________________ Rental Unit?_________________ Monthly Rent Received $_____________

Page 10

Initials __________

Item 23.

Other Assets

List all other property, by category, with an estimated value of $2,500 or more, held by the corporation, including but not
limited to, inventory, machinery, equipment, furniture, vehicles, customer lists, computer software, patents, and other
intellectual property.
Property Category

Property Location

Acquisition
Cost

Current
Value

____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________
____________________________ _____________________________________________ $__________ $_________

Item 24.

Trusts and Escrows

List all persons and other entities holding funds or other assets that are in escrow or in trust for the corporation.
Trustee or Escrow Agent’s
Name & Address

Description and Location of Assets

Present Market
Value of Assets

______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________
______________________________________ _______________________________________ $_________________

Page 11

Initials __________

Item 25.

Monetary Judgments and Settlements Owed To the Corporation

List all monetary judgments and settlements, recorded and unrecorded, owed to the corporation.
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________

Item 26.

Monetary Judgments and Settlements Owed By the Corporation

List all monetary judgments and settlements, recorded and unrecorded, owed by the corporation.
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit_______________________________________ Date______________ Amount $______________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________
Opposing Party’s Name & Address___________________________________________________________________
Court’s Name & Address____________________________________________________ Docket No._____________
Nature of Lawsuit______________________________ Date of Judgment________________ Amount $____________

Page 12

Initials __________

Item 27.

Government Orders and Settlements

List all existing orders and settlements between the corporation and any federal or state government entities.
Name of Agency ___________________________________________ Contact Person __________________________
Address _____________________________________________________________ Telephone No. _______________
Agreement Date ______________ Nature of Agreement __________________________________________________

Item 28.

Credit Cards

List all of the corporation’s credit cards and store charge accounts and the individuals authorized to use them.
Name of Credit Card or Store

Names of Authorized Users and Positions Held

__________________________________________ _____________________________________________________
__________________________________________ _____________________________________________________
__________________________________________ _____________________________________________________
__________________________________________ _____________________________________________________
__________________________________________ _____________________________________________________

Item 29.

Compensation of Employees

List all compensation and other benefits received from the corporation by the five most highly compensated employees,
independent contractors, and consultants (other than those individuals listed in Items 5 and 6 above), for the two previous
fiscal years and current fiscal year-to-date. “Compensation” includes, but is not limited to, salaries, commissions,
consulting fees, bonuses, dividends, distributions, royalties, pensions, and profit sharing plans. “Other benefits” include,
but are not limited to, loans, loan payments, rent, car payments, and insurance premiums, whether paid directly to the
individuals, or paid to others on their behalf.
Name/Position

Current Fiscal
Year-to-Date

1 Year Ago

2 Years Ago

Compensation or
Type of Benefits

_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________

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Initials __________

Item 30.

Compensation of Board Members and Officers

List all compensation and other benefits received from the corporation by each person listed in Items 5 and 6, for the
current fiscal year-to-date and the two previous fiscal years. “Compensation” includes, but is not limited to, salaries,
commissions, consulting fees, dividends, distributions, royalties, pensions, and profit sharing plans. “Other benefits”
include, but are not limited to, loans, loan payments, rent, car payments, and insurance premiums, whether paid directly to
the individuals, or paid to others on their behalf.
Name/Position

Current Fiscal
Year-to-Date

1 Year Ago

2 Years Ago

Compensation or
Type of Benefits

_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
_____________________________ $____________ $___________ $____________ ___________________________
Item 31.

Transfers of Assets Including Cash and Property

List all transfers of assets over $2,500 made by the corporation, other than in the ordinary course of business, during the
previous three years, by loan, gift, sale, or other transfer.
Transferee’s Name, Address, & Relationship

Property
Transferred

Aggregate
Value

Transfer
Date

Type of Transfer
(e.g., Loan, Gift)

______________________________________ ________________ $____________ __________ _________________

______________________________________ ________________ $____________ __________ _________________

______________________________________ ________________ $____________ __________ _________________

______________________________________ ________________ $____________ __________ _________________

______________________________________ ________________ $____________ __________ _________________

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Initials __________

Item 32.

Documents Attached to the Financial Statement

List all documents that are being submitted with the financial statement.
Item No. Document
Relates To

Description of Document

___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________
___________________ ____________________________________________________________________________

I am submitting this financial statement with the understanding that it may affect action by the Federal Trade
Commission or a federal court. I have used my best efforts to obtain the information requested in this statement. The
responses I have provided to the items above are true and contain all the requested facts and information of which I have
notice or knowledge. I have provided all requested documents in my custody, possession, or control. I know of the
penalties for false statements under 18 U.S.C. § 1001, 18 U.S.C. § 1621, and 18 U.S.C. § 1623 (five years imprisonment
and/or fines). I certify under penalty of perjury under the laws of the United States that the foregoing is true and correct.
Executed on:
______________________________
(Date)

_____________________________________________________
Signature

_____________________________________________________
Corporate Position

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Initials __________