Financial Statement (Personal)

Simply complete the Financial Statement (Personal) form below then click on View Results to see your completed contract.

LawDepot's Financial Statement (Personal) is ideal for:

  • evaluating whether you should loan money to someone.
  • presenting a snapshot of your financial situation.
  • calculating your net worth.
We regularly maintain this contract. Last Modified: February 2013
Financial Statement (Personal) Details
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This software has the flexibility to let you quickly create the Financial Statement you want. It does this by providing many options with appropriate defaults.

Leave an answer empty if you want a blank line in place of the answer in order to complete it after printing, but before it is executed.

Applicant Information

Number of Applicants: 

Applicant
Name:
Address:
(e.g. Street, City, Province, Country, Postal Code)
Phone Number: (e.g. (555) 555-5555)
Applicant's employer?
Applicant's position with the employer?
How long Applicant has held this position?
(e.g. three years, two months, etc.)
Purpose of Financial Statement

Name of receiving party:
Who you are making this statement for.
Address:
Enter the address for the party receiving this statement. (e.g. Street, City, Province, Country, Postal Code)
Purpose of statement:

Describe why you are making this personal financial statement.
(e.g. obtaining a mortgage)
(e.g. guaranteeing a loan)

Cash on Hand:  $

Number of Bank Accounts: 
Number of Debts Owed to Applicant: 
Number of Retirement Accounts: 
Number of Investments: 
Number of motor vehicles: 
Number of life insurance policies: 
Number of real estate properties: 
Number of Other Assets: 
Total Value of Assets:
This value is automatically calculated based on the values submitted for the above assets. It cannot be changed manually.


Number of loans from financial institutions: 
How many other loans do you have? 

Unpaid taxes:  $
Enter the amount of all unpaid taxes the Applicant is responsible for.

Number of credit cards: 
Number of Other Liabilities: 

Total Value of Liabilities:
This value is automatically calculated based on the values submitted for the above liabilities. It cannot be changed manually.

Net Worth Value:
Applicant's Source of Income

Enter the following values to the nearest dollar (e.g. 4,435).

Applicant
Salary:  $
Commission/Bonus Income:  $
Real Estate Income:  $
Investment Income:  $

Number of other sources of income:


Total Income:  
This value is automatically calculated based on the values submitted for the above sources of income. It cannot be changed manually.
Applicant's Contingent Liabilities Q. What are "contingent liabilities"? A. Contingent liabilities are potential debts that you will be responsible for if certain events occur in the future. Contingent liabilities may arise from any of the following:
  • pending lawsuits;
  • disputed claims;
  • cases under appeal;
  • possible tax assessments; or
  • contract disputes.

Contingent liabilities are liabilities that you are only responsible for if a certain specified event happens. Please enter the value of the following contingent liabilities to the nearest dollar (e.g. 4,435). If a contingent liability does not apply to you then fill in the value as 0.

Applicant
Are you acting as an endorser or guarantor on a loan for someone else? Q. What is an "endorser" or "guarantor"? A. An endorser or guarantor is a person who agrees to pay any losses directly to the lender should the debtor default. If you are an endorser or guarantor, you are in effect, assuming the financial responsibilities of another person(s) debt if they default on their loan payments.
Do you owe money as the result of any legal claims/judgments made against you?
Other Contingent Liabilities: 

Total Contingent Liabilities: 0
This value is automatically calculated based on the values submitted for the above contingent liabilities. It cannot be changed manually.
Date Information is Accurate:
 
Enter the date by which all of the information provided on this Personal Financial Statement is accurate.