Financial Statement-State Of California Form

Download a blank fillable Financial Statement-State Of California 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 Financial Statement-State Of California 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

Financial Statement
STATE OF CALIFORNIA
FRANCHISE TAX BOARD
INFORMATION WILL BE VERIFIED (FILL OUT FINANCIAL STATEMENT COMPLETELY)
Taxpayer:
Phone Numbers (Circle best daytime number):
Address:
Home:
Work:
City:
State:
ZIP:
Spouse’s Work:
Driver License Number:
Personal Fax:
Spouse:
Social Security Numbers:
Date of Birth:
Address:
Taxpayer:
Taxpayer:
City:
State:
ZIP:
Spouse:
Spouse:
Driver License Number:
LIST ALL DEPENDENTS AND NON-RELATIVES LIVING WITH YOU If additional space is needed, attach a separate sheet.
Name:
Age:
Relationship:
Name:
Age:
Relationship:
Name:
Age:
Relationship:
Name:
Age:
Relationship:
Name:
Age:
Relationship:
Name:
Age:
Relationship:
EMPLOYMENT INFORMATION
EMPLOYMENT INFORMATION
TAXPAYER
SPOUSE
Employer/Business Name:
Employer/Business Name:
Address:
Address:
City:
State:
ZIP:
City:
State:
ZIP:
Employer/Business Phone Number:
Employer/Business Phone Number:
Employer/Business Fax Number:
Employer/Business Fax Number:
Occupation/Profession:
Occupation/Profession:
How long employed:
How long employed:
Marital status on your W-4:
Single
Married
Marital status on your W-4:
Single
Married
Number of exemptions you claim:
Number of exemptions you claim:
BANK ACCOUNTS Include Savings & Loans, Credit Unions, CD’s, IRA’s. If additional space is needed, attach separate sheet.
Type of Account
Name of Institution
Address
Account No.
Balance
(Checking/Savings)
(Joint/Separate)
REAL ESTATE If additional space is needed, attach separate sheet.
Address/County of Property
Date Purchased
Current Value
Mortgage Balance
Paid to: (Lender Name)
MOTOR VEHICLES If additional space is needed, attach a separate sheet.
Year, Make, and License Number
Date Purchased
Current Value
Loan Balance
Date Loan Will Be Paid Off
1.
2.
3.
LIFE INSURANCE If additional space is needed, attach a separate sheet.
Amount You Can
Amount You Can
Name of Company
Name of Company
Borrow on Policy
Borrow on Policy
OTHER ASSETS Things you own or are buying, such as stocks, bonds, boats, etc. If additional space is needed, attach a separate sheet.
Description
Current Value
Loan Balance
Date Loan Will Be Paid Off
FTB 3561 C2 (REV 7-97) PAGE 1

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 3