Financial Worksheet
Borrower’s Name(s):__________________________
oan Number:_____________________________
L
Names:
Social Security Number:
Names:
Social Security Number:
Home Telephone Number:
Work Telephone Number: ( )
(
)
If necessary, who should we call to set up an appointment to
**How many members are in the household? ________
appraise the property:
Property Address
Street Address, City, State, Zip Code
,
Mailing Address (If different than property address)
Rent
Own How long? ___________
Street Address, City, State, Zip Code
I. Monthly Income Data
Description
Income Borrower
Income Co-borrower
Total
Net Salary/Wages
Commissions/Bonuses
Other (Identify)
Total Net Income
II. Assets
III. Liabilities
Description
Estimated Value
Description
Monthly Payment
Balance Due
Home
Mortgage
Other Real Estate (explain)
Other Mortgages/Rent
Automobile
Alimony/Child Care
Automobile
Automobile Expenses (oil, gas, etc.)
Checking Accounts
Automobile Insurance
Savings/Money Market
Food
IRA/Keogh Accounts
Utilities (total)
401K/ESOP Accounts
Insurance
Stock/Bonds, CD’s
Student Loan
Investments
Credit Card
Other
(explain)
Other Expenses (identify)
Total
I (we) certify that the financial information stated above is true, and is an accurate statement of my /our financial condition.
I/WE understand and acknowledge that any action taken by the lender of my /our mortgage loan on my/our behalf will be made
in strict reliance on the financial information provided. My/Our signature (s) below grants the holder of my/our mortgage the
authority to obtain a credit report to verify the information in this financial to be accurate.
By:______________________ Date: ___/___/___ By: ________________________ Date: _____/___/____
Final Instructions
Make Sure you have signed and dated the form.