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Statement of Financial Position - General

MISSOURI DEPARTMENT OF HEALTH AND SENIOR SERVICES DIVISION OF REGULATION AND LICENSURE SECTION FOR LONG TERM CARE REGULATION Statement OF Financial Position General All forms may be found on our website at: OPERATOR DATE CURRENT ASSETS 1. Cash 2. Accounts receivable 3. Notes receivable 4. Inventories 5. Prepaid expenses 6. Other current assets PROPERTY AND EQUIPMENT AT COST 7. Land and land improvements 8. Buildings and improvements 9. Equipment 10. Furniture and fixtures 11. Less: accumulated depreciation 12. Net property and equipment OTHER ASSETS 13.

The Statement of Financial Position (balance sheet) may be used by general business corporations,partnerships, nonprofitcorporations, limitedliability companies, and governmental entitieswhen submitting informationrequired by the Application for License to Operate a Long­

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