Personal Financial Statement Form Page 2
Download a blank fillable Personal Financial Statement Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Personal Financial Statement Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2PERSONAL FINANCIAL SCHEDULES
Include schedule totals on Page 1 where indicated
SCHEDULE A STOCKS AND BONDS
compAny
number of shAres
mArKet VAlue As of:
owner
1
2
3
4
SCHEDULE B REAL ESTATE
ADDress (city/stAte/zip)
property type (RES/Comm)
owner
DAte purchAseD
purchAse price
mArKet VAlue
rent receiVeD
1
2
3
4
SCHEDULE C REAL ESTATE MORTGAGE AND HOME EQUITY LOANS FOLLOW ORDER OF SCHEDULE B
lenDer
oriGinAl bAlAnce
current bAlAnce
monthly pAyment
rAte
mAturity
1
2
3
4
SCHEDULE D CREDIT CARDS / REVOLVING LOANS
lenDer
oriGinAl bAlAnce
current bAlAnce
monthly pAyment
rAte
mAturity
1
2
3
4
SCHEDULE E INSTALLMENT / OTHER
lenDer
oriGinAl bAlAnce
current bAlAnce
monthly pAyment
rAte
mAturity
1
2
3
4
DECLARATIONS
PLEASE PROVIDE DETAILS ON AN ADDITIONAL PAGE TO ANY QUESTIONS WITH A YES RESPONSE
K
K
yes
no
is the owner or any of the proposed guarantors party to any lawsuit or subject to outstanding judgements?
K
K
yes
no
is the owner or any of the proposed guarantors party to taxes or credit obligations past due? Amount: $_________________ payable to: __________________________________________
K
K
yes
no
has the owner or any of the proposed guarantors ever filed personal bankruptcy or served as an officer in a company that declared bankruptcy?
K
K
yes
no
is the owner or any of the proposed guarantors presently under indictment or probation or parole, or ever been charged or convicted for any criminal offense other than a minor motor
vehicle violation?
K
K
yes
no
is the owner or any of the proposed guarantors, a political party, a campaign, a candidate, a public official or foreign political official or an immediate family member of such an official, or a
business entity formed by or for the benefit of any public official?
if yes, name, relationship and position of official: ____________________________________________________________________________________________________________________
K
K
yes
no
is the owner a us citizen? if not, list country of residence (or enter resident Alien): ________________________________________________________________________________________
K
K
yes
no
is the owner, an owner of the applicant, or any of the proposed guarantors an employee of surety bank or one of its affiliates? if yes, employee name: __________________________________
OWNER/GUARANTOR SIGNATURES
________________________________________________________________________
________________________________________________________________________
nAme of primAry owner/GuArAntor (pleAse print)
nAme of seconDAry owner/GuArAntor (pleAse print)
________________________________________________________________________
________________________________________________________________________
siGnAture
DAte
siGnAture
DAte
AUTHORIZATION
The owner(s)/guarantor(s) signing above hereby authorize the Lender, and any of its duly authorized agents, to obtain and use my/our credit reports and to exchange credit information in connection with this business loan application and any update, renewal,
account review or extension the Lender may require. Additionally, I/we hereby authorize the Lender to obtain my/our personal credit report(s), and/or to make employment or investigation inquiries deemed necessary by the Lender in connection with this
business loan application. I/we have a right to ask if a consumer credit report was requested, and if a report was requested, and if I/we ask, I/we will be informed of the name and address of the consumer reporting agency that furnished the report. I/we
understand and agree that the Bank can furnish information concerning our personal or business accounts to consumer reporting agencies and others who may properly receive that information. It is understood that a photocopy or fax of this form will also serve
as authorization. I/we understand that I/we must update this credit information at the Lender’s request and/or if my/our financial condition changes. Each individual signing above authorizes and requests Lender to share the information provided on this
application, together with (i) the results of its investigation of the credit and financial condition of the company and each applicant and (ii) consumer credit reports on each owner/guarantor, with the U.S. Small Business Administration (“SBA”) and/or Surety
Bank in order to allow Lender to offer the credit product best suited to the company and each owner’s/guarantor’s financing needs.
Lender complies with section 326 of the USA Patriot Act. Lender may also ask to see your driver’s license or any other photo identifying documentation. This law mandates that Lender verify certain information about you, including your name, legal address,
date of birth, and Social Security or tax identification number, while processing your account application.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial