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INSTRUCTIONS FOR COMPLETING THE PERSONAL FINANCIAL STATEMENT

A complete description of all installment accounts is required in Section 2. This does not include debts in the name

of the firm.

Installment Account (Auto) balance: Enter the remaining balance for auto loans held by the firm owner personally

in the block at the far right; indicate the amount of monthly payment(s) in the space provided in the left‐hand

block.

Installment Account (other) balance: Enter the total remaining balance for all installment accounts held by the

firm owner personally; do not include auto loan accounts, which should be covered in the box above. Details for

installment account(s) will be required in section 2 on page 2.

Loans on Life Insurance: Enter the total value of all loans due on Life Insurance Policies. A complete description is

required in Section 8 on page 2 of the Statement.

Mortgages on Real Estate: Enter the total value due on all mortgage(s) payable on Real Estate. Two types of real

estate mortgages are NOT included in this total: (1) any mortgage(s) on the firm owner’s primary residence and (2)

mortgages on any property held in the name of the firm. A complete breakdown of all real estate mortgage(s)

listed in this space will be required in Section 4 on page 2 of the Statement.

Unpaid Taxes: Enter the total amount of all taxes that are currently due, but are unpaid. Contingent tax liabilities

or anticipated taxes for current year should not be included. A complete description is required in Section 6 on

page 2 of the Statement.

Other Liabilities: Enter the total value due on all other liabilities not classified in the previous section. A complete

description is required in Section 7 on page 2 of the Statement. List only your personal liabilities, not liabilities in

the name of your firm.

SECTION 1

SOURCE OF INCOME

Salary: Enter the amount of your total annual salary. This includes any salary from the applicant firm and if

applicable, any salary from outside employment.

Net Investment Income: Enter the total amount of all personal investment income (for example, dividends,

interest, etc.).

Real Estate Income: Enter the total amount of all real estate income you received from the sale, rental, lease, or

other transactions related to real estate. This includes only income in your name, or your share of joint income,

and not income in the name of your firm.

Other Income: Enter the total amount of all other income received (for example, alimony, Social Security, Pension,

etc.). Please be sure to describe the source of the other income in the space provided at the bottom of Section 1.

CONTINGENT LIABILITIES

As Endorser or Co‐Maker: Enter the total potential liabilities due as a result of being a co‐signer for a loan or other

commitments.

Legal Claims and Judgments: Enter your potential liabilities that may result due to legal claims from judgments,

lawsuits, or other legal matters. Include your share of any joint claim or liability (see note at end of these

instructions for married applicants). Do not include claims and liabilities in the name of your firm.

Form Sba Form 413 - Personal Financial Statement/adjusted Personal Net Worth Worksheet Page 7