dnb info form

Welcome to Dun & Bradstreet. The information you provide will be used as a basis for credit, insurance, marketing and other business decisions. A Dun & Bradstreet business analyst may contact you upon receipt of this completed form to clarify some of the information

2 - OPERATIONS - A DESCRIPTION OF THE BUSINESS FUNCTION
Describe what the business does: Manufacturing push switch from pat.5360997 and software
Do you offer your product or service on	X CASH		If you offer credit - please
and or	� CREDIT		specify billing terms ______________________
Sales territory is International		The customers of this		�X THE GENERAL PUBLIC
X LOCAL X NATIONAL		business are primarily		☐ COMMERCIAL ACCOUNTS
X REGIONAL X INTERNATIONAL				☐ OTHER __________________
				(Please Specify)

3 - HISTORY OF THE BUSINESS - HOW THE BUSINESS GOT STARTED
The legal structure is	Is trade style registered	The dollar amount used to start
X Proprietorship	☐ YES ☐ NO	this business was $_5,000
☐ Partnership
☐ Corporation		This money came from:OWNER
☐ Other*	If trade style is registered:	Loans from the owners $_______ Savings $_______
* Specify ___________________	City/Town Registered_________________	*Other $_______
Date incorporated_____________	Date registered______________	*Please specify:______________
State where incorporated_______		__________________________

4-BACKGROUND INFORMATION ON THE OWNER(S) / OFFICERS
For the owner(s) outlined in section 1, complete the following (if there are more than 3 owners, attach their resumes to this form):
Owner #1		Owner #2				Owner #3
Title: MR.Gerald Daniel Krug Year of Birth __02/26/1958 College _Glendale College Degree Received ________________ Date Received_________________ % Stock Ownership_______________		Title: _________________________ Year of Birth ___________________ College _______________________ Degree Received ________________ Date Received _____________________ % Stock Ownership_______________				Title: _________________________ Year of Birth ___________________ College _______________________ Degree Received ________________ Date Rec’d _____________________ % Stock Ownership_______________
List previous work experience for each owner from age 21 or back 25 years from the prest date OR ATTACH RESUME.
Name	Positions Held		Yr Started	Yr Ended	Company Name		City	State
Owner #1	Pinsetter Mechanic		1980	2002	Jewel City Bowl
	Exterior Electrician		1980	2001	Horace Heidts
	Maintenance Mechanic		1976	1978	Person & Covey

Name	Positions Held		Yr Started	Yr Ended	Company Name		City	State
Owner #2



Name	Positions Held		Yr Started	Yr Ended	Company Name		City	State
Owner #3



List other current and/or previous businesses owned for each owner:

Owner #1:____Author "The Program Begins" sub-title "Over 50 programs on the TRS-80 PC-4"
Owner #2 ______________________________________________________________________________
Owner #3 ______________________________________________________________________________

5 - LIST OF SUPPLIERS/BANK(S) - THOSE WITH WHOM YOU HAVE ACCOUNTS
Supplier Names	City	State	Phone Number	Account Number	Contact Person
1.www.lulu.com	860 Aviation Parkway, Suite 300	Morrisville, NC 27560	none	dont know	Bob Young
2.www.amazon.com	P.O. Box 81226	Seattle, WA 98108-1226	none	dont know	Jeffrey P.Bezos
3.www.paypal.com		San Jose, California	1-402-935-2050		www.ebay.com
4.AT&T			1-800-310-2355
5.Qwest Communications			1-800-860-1020
6.www.ccr.gov				1kk56	Romeo

Bank Names	City	State	Phone Number	Account Number	Contact Person
1.WAMU	VAN NUYS	CA	818.778.0500	0923652532
2.Capital One

(It is not necessary to complete this section if you wish to attach a copy of your current balance sheet. A FISCAL STATEMENT IS PREFERRED). Please include figures to the exact dollar (cents not required). Blank spaces are provided for statement items that do not fall into the specified categories.

Cash $ 2,000		Accounts Payable $	0
Accounts Receivable	0	Bank Loans	0
Inventory 0		Note Payable*	0
Notes Receivable 0
Marketable Securities 0		Accruals	0
		Taxes	0
		Loans & Advanc-Principals 0
		Long Term Liab.-Other* 0
Other Current Assets* 0		Other Current Liabilities* 0
CURRENT ASSETS 0		CURRENT LIABILITIES 0
Fixtures/Equipment 0		Mortgages 0
		Long Term Liab-Other* 0
Real Estate 0		Def.Credits/Income* 0
CVS of Life Ins. 0		CAPITAL STOCK 0
Investment-Other* 0		PREFERRED STOCK	0
Deposits 0		COMMON STOCK 0
		ADDITIONAL PAID IN CAP. 0

		RETAINED EARNINGS 0
		NET WORTH 0
Other Assets*
TOTAL ASSETS $ 2,000		TOTAL LIAB./CAP. $	0

Please explain all items indicated by an *: __________________________________________________

_____________________________________________________________________________________

Depreciation on Fixed Assets $: __________________________________________________________

____ Reviewed by: ____________________________ Title ____________________ Date _________

Sales		19.95
Cost of Goods Sold+Amazon.com		17.80..16.11+1.69
_________________________________
Gross Profit		2.15
Operating Expense		0
_________________________________
Operating Income (Loss)		2.15
Other Income		0
Other Expenses		0
Net Income Before Taxes		0
Income Tax		0
Other Tax		0
_________________________________
_________________________________
_________________________________
_________________________________
Net Income		2.15
Net Loss		0
_________________________________

1 - GENERAL INFORMATION
Business Name	Gerald Daniel Krug	DBA	Gerald Daniel Krug		EIN 47-1373219
Street Address	14660 Oxnard st.				Business started		1/01/1994
City,State	Van Nuys,Calif.	Zip Code		91411	Number of full & part-time
Mailing Address	P.O.Box 5552 Sherman Oaks,Calif.91413				employees, including owners _1__
Names:	1.	Title:
(Owners/Officers)	2.Gerald Krug	Title:	Owner		Work Phone	(877)-619-2277
	3.	Title:			Home Phone:	(818)-430-2452

FIRE INSURANCE: Inventory	$0	MONTHLY RENT	$ 0
Inventory and Fixtures:	$0	LEASE EXPIRES
Inventory, Fixtures & Building:	$0

			TO
Mo.1	Day31	Year2007		Mo.1	Day31	Year2008

D&B D-U-N-S #:968794859	Date: 2/03/07
To:William Taylor	From: Gerald Krug
Co/Dept:Dunn & Bradstreet	Co: Gerald Daniel Krug
Phone #: 1-800-333-0505	Phone #: 1-877-619-2277
Fax #:	Fax #: upon request