PERSONAL FINANCIAL STATEMENT
PERSONAL FINANCIAL STATEMENT as of December 5, 2016 OF _________________________ of _________________________ (the "Applicant") FOR _________________________ of _________________________.
This Personal Financial Statement is being made for the purpose of: ________________________________________________________________________.
Applicant #1 Personal InformationName: _________________________Address: _________________________Phone: __________Employer: _________________________Position: _________________________Number of Years at Position: _________________________
Section 1. Balance Sheet
Cash on hand
Cash in Bank
Loans Payable to Financial Institution
Debt Owed to Applicant
Amount Owing on Motor Vehicle
Amount Owing on Real Estate
Cash Value Life Insurance
Net Worth Calculation:
Section 2. Contingent Liabilities
Real Estate Income
Other Contingent Liabilities
The Applicant certifies that all the information provided in this statement is true and accurate as of December 5, 2016. The Applicant authorizes _________________________ to make any inquiries that _________________________ feels is necessary to verify the information in this financial statement.
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