Form CM-2 "Statement of Financial Condition and Other Information - for Individuals" - Hawaii

What Is Form CM-2?

This is a legal form that was released by the Hawaii Department of Taxation - a government authority operating within Hawaii. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2018;
  • The latest edition provided by the Hawaii Department of Taxation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form CM-2 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Taxation.

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Download Form CM-2 "Statement of Financial Condition and Other Information - for Individuals" - Hawaii

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Clear Form
Form CM - 2
Department of Taxation - State of Hawaii
(Rev. 2018)
STATEMENT OF FINANCIAL CONDITION AND OTHER INFORMATION
Section I.
General Information - For Individuals
1. Taxpayer(s) name(s) and address
2. Home phone no.
3. Marital status
4a. Taxpayer's social security no.
b. Spouse's social security no.
5a. Taxpayer's birth date
b. Spouse's birth date
6. Other names or aliases
7. Name, age, social security number, and relationship of dependents living in your household.
Section II.
Employment Information
8. Taxpayer's employer or business
a. How long employed?
b. Business phone no.
c. Occupation
(name and address)
d. Check appropriate item
( ) Wage earner
( ) Sole proprietor
( ) Partner
9. Spouse's employer or business
a. How long employed?
c. Business phone no.
c. Occupation
(name and address)
d. Check appropriate item
( ) Wage earner
( ) Sole proprietor
( ) Partner
Section III.
General Financial Information
10. Bank accounts (include Savings & Loans, Credit Unions, IRA and Retirment Plans, Certificate of Deposits, etc.)
Attach additional sheets as necessary.
Name of Institution
Address
Type of Account
Account No.
Balance
Total (Enter in Item 17)
ID NO 01
CM2_I 2018A 01 VID01
Form CM-2 Page 1
Form CM-2 Page 1
Clear Form
Form CM - 2
Department of Taxation - State of Hawaii
(Rev. 2018)
STATEMENT OF FINANCIAL CONDITION AND OTHER INFORMATION
Section I.
General Information - For Individuals
1. Taxpayer(s) name(s) and address
2. Home phone no.
3. Marital status
4a. Taxpayer's social security no.
b. Spouse's social security no.
5a. Taxpayer's birth date
b. Spouse's birth date
6. Other names or aliases
7. Name, age, social security number, and relationship of dependents living in your household.
Section II.
Employment Information
8. Taxpayer's employer or business
a. How long employed?
b. Business phone no.
c. Occupation
(name and address)
d. Check appropriate item
( ) Wage earner
( ) Sole proprietor
( ) Partner
9. Spouse's employer or business
a. How long employed?
c. Business phone no.
c. Occupation
(name and address)
d. Check appropriate item
( ) Wage earner
( ) Sole proprietor
( ) Partner
Section III.
General Financial Information
10. Bank accounts (include Savings & Loans, Credit Unions, IRA and Retirment Plans, Certificate of Deposits, etc.)
Attach additional sheets as necessary.
Name of Institution
Address
Type of Account
Account No.
Balance
Total (Enter in Item 17)
ID NO 01
CM2_I 2018A 01 VID01
Form CM-2 Page 1
Form CM-2 Page 1
Section III.
General Financial Information - continued
11. Charge cards, lines of credit (attach additional sheets as necessary).
Type of Account
Name and address of Financial Institution
Monthly
Credit
Amount
Credit
or Card
Payment
Limit
Owed
Available
Total (Enter in Item 25)
12. Safe deposit boxes rented or accessed (List all locations, box numbers, and contents.)
13. Real and lease property (Brief description and type of ownership)
Physical Address (include tax map key)
14. Life Insurance (Name of Company)
Policy Number
Type
Face Amount
Loan Value
Total (Enter in Item 19)
15. Securities (stocks, bonds, mutual funds, money market funds, etc.) Attach additional sheets if needed.
Quantity or
Current
Where
Owner
Kind
Denomination
Value
Located
of Record
Form CM-2 Page 2
Section IV.
Asset and Liability Analysis
Current
Liabilities
Equity
Amount of
Market
Balance
in
Monthly
Description
Value
Due
Asset
Payment
ASSETS
16. Cash
17. Bank accounts (from Item 10)
18. Securities (from Item 15)
19. Cash or loan value of Insurance (from Item 14)
20. Accounts Receivable
21. Merchandise Inventory
22. Vehicles (Model, year, license)
a.
b.
c.
23. Real property (from Item 13)
a.
b.
c.
24. Other assets
a.
b.
c.
d.
e.
f.
Total Assets
LIABILITIES
25. Bank revolving credit (from Item 11)
26. Loan on Insurance
27. Accounts payable
28. Notes payable
29. Mortgages
30. Judgments
31. Other liabilities
a.
b.
c.
d.
e.
f.
Total Liabilities
Form CM-2 Page 3
Section V.
Monthly Income and Expense Analysis
Income
Source
Gross
Net
Necessary Living Expenses
32. Wages/Salaries (Taxpayer)
43. Rent
33. Wages/Salaries (Spouse)
44. Groceries (no. of people ______)
34. Interest - Dividends
45. Utilities (Gas _______ Water _______
35. Net business income
Electric _______ Phone _______)
36. Rental Income
46. Transportation
37. Pension (Taxpayer)
47. Insurance (Home _______ Car ______
38. Pension (spouse)
Life _______ Health _______)
39. Child Support
48. Medical
40. Alimony
49. Estimated tax payments
41. Other
50. Court ordered payments
51. Other expenses (please specify)
42. Total Income
52. Total Expenses
53. Net difference (income less necessary
living expenses)
Certification
Under penalties of perjury, I declare that to the best of my knowledge and belief this statement
of assets, liabilities, and other information is true, correct, and complete.
54. Your signature
55. Spouse's signature (if joint return was filed)
56. Date
Form CM-2 Page 4
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