Uniform Residential Loan Application - 2009 Page 4
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16VI. ASSETS AND LIABILITIES (cont’d)
Name and address of Bank, S&L, or Credit
Acct. no.
Union
Acct. no.
$
Name and address of
$ Payment/
$
Months
Company
Name and address of Bank, S&L, or Credit
Union
Acct. no.
Acct. no.
$
Name and address of
$ Payment/
$
Months
Company
Name and address of Bank, S&L, or Credit
Union
Acct. no.
Acct. no.
$
Name and address of
$ Payment/
$
Months
Company
Stocks & Bonds
$
(Company
name/number & description)
Acct. no.
Life insurance net cash
$
Name and address of
$ Payment/
$
Months
value
Company
Face amount: $
Subtotal Liquid Assets
$
Acct. no.
Real estate owned
$
Alimony/Child
$
$
Support/Separate
(enter market value from
schedule of real estate owned)
Maintenance Payments
Owned to:
Vested interest in
$
retirement fund
Net worth of business(es)
$
Job-Related Expense
$
owned
(child care, union dues, etc.)
(attach financial statement)
Automobiles owned
$
(make and year)
Other Assets
$
(itemize)
Total Monthly Payments
$
Total Assets
$
Net Worth
$
Total Liabilities
$
a.
(a minus b)
b.
Uniform Residential Loan Application
Page 4 of 8
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