Form Cfs - Comprehensive Financial Statement Page 2
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6EFO00122
Financial Statement Page 2
08-23-10
SECTION 3. GENERAL FINANCIAL INFORMATION (Personal and Business)
Include IRA and retirement plans, certificates of deposit, etc. For all accounts, attach copies of your last three statements. Attach
Bank accounts.
additional pages as needed.
Name of institution
Address
Type
Date opened
Account number
Balance
TOTAL. Enter this amount on line 2, Section 4 (Asset and Liability Analysis) ........
$
Vehicles.
Attach additional pages as needed.
Year, make, model, license number
Lender/Lien holder
Current market value
Current payoff
Available equity
TOTAL. Enter this amount on line 3, Section 4 (Asset and Liability Analysis) ........
$
Personal Property.
Include watercraft, RV’s, ATV’s, aircraft, business equipment, and/or machinery. Attach additional pages as needed.
Year, make, model, license number
Lender/Lien holder
Current market value
Current payoff
Available equity
TOTAL. Enter this amount on line 4, Section 4 (Asset and Liability Analysis) ........
$
Life Insurance.
Attach additional pages as needed.
Name of insurance company
Agent’s name and telephone number
Policy number
Whole life or term
Loan/Cash value
TOTAL. Enter this amount on line 5, Section 4 (Asset and Liability Analysis) ........
$
Securities.
Include stocks, bonds, mutual funds, money market funds, securities, etc. Attach additional pages as needed.
Type
Where located
Owner of record
Quantity or denomination
Current value
TOTAL. Enter this amount on line 6, Section 4 (Asset and Liability Analysis) ........
$
Safe deposit Boxes.
Include locations, box numbers, and contents. Attach additional pages as needed.
Name of institution
Address
Box identification
Current value of assets
TOTAL. Enter this amount on line 7, Section 4 (Asset and Liability Analysis) ........
$
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