EFO00122
Financial Statement Page 3
8-23-10
SECTION 3. GENERAL FINANCIAL INFORMATION (Personal and Business)–continued
Real Property.
Attach additional pages as needed.
A. Physical address and description (single family dwelling, multi-family dwelling, lot, etc.)
Mortgage lender’s name and address
Purchase date:____________ Purchase price:_______________ Mortgage payoff amount:_________________ Current value:_______________
B. Physical address and description (single family dwelling, multi-family dwelling, lot, etc.)
Mortgage lender’s name and address
Purchase date:____________ Purchase price:_______________ Mortgage payoff amount:_________________ Current value:_______________
C. Physical address and description (single family dwelling, multi-family dwelling, lot, etc.)
Mortgage lender’s name and address
Purchase date:____________ Purchase price:_______________ Mortgage payoff amount:_________________ Current value:_______________
TOTAL. (Current values A, B, and C minus mortgage payoff) Enter this amount on line 19, Section 4 (Asset and Liability Analysis) .... $
Credit Cards.
Attach additional pages as needed.
Type of account
Name and address of creditor
Monthly payment
Credit limit
Credit available
Amount owed
Total
$
TOTAL. Enter this amount on line 21, Section 4 (Asset and Liability Analysis) ......
$
transfers, Repossessions, etc.
List any vehicles, equipment, or property sold, given away, or repossessed during the past year.
Attach additional pages as needed.
Year, make, model of vehicle, or property address
Who took possession and relationship
Date of transfer