Sublet Application Form Page 10
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19Part II – Financial Information
P urc hase r:
Co-P urc hase r:
Ad dre ss:
Ad dre ss:
SOURCE OF INCOME & REGULAR EXPENSES
INCOME (ANNUAL)
Purchaser
Co-Purchaser
EXPENSES MONTHLY:
Purchaser
Co-Purchaser
Base Salary
Maintenance
Overtime Wages
Apartment Financing
Bonuses
Other Mortgages
Commissions
Rea l Estate Taxes
Dividends & Interest Income
Bank Loans
Real Estate Income (Net)
Auto Loa n
Other Income (Itemize)
Credit Card Debt
TOTAL INCOME
TOTAL
ASSESTS & LIABILITIES
ASSETS
Purchaser
Co-Purchaser
LIABILITIES
Purchaser
Co-Purchaser
Ca s h/Money Market Funds (Sched. A)
Notes Payable:
__________
_________
Contra ct Deposit
to Banks
__________
_________
Bonds, Stocks, Brokerage Acc. (Sched. B)
to Relatives
__________
_________
Investment in Own Business
to Others
__________
_________
Accounts & Notes Receivable
Installment Accounts Payable:
__________
_________
Rea l Estate Owned (Sched. C)
Automobile
__________
_________
Automobiles (Blue Book Value)
Other
__________
_________
Personal Property & Furniture
Mortgages Payable on Real Estate
Life Insurance (Cash Surrender Value)
Unpaid Real Estate Taxes
__________
_________
Retirement Funds /IRA
Unpaid Income Taxes
__________
_________
401K
Chattel Mortgages
__________
_________
KEOGH
Loa ns on Life Insurance Policies
__________
_________
Profit Sharing/Pension Plan
Outstanding Credit Card Debt
__________
_________
Other Assets (Sched. D)
TOTAL LIABILITIES
__________
_________
TOTAL ASSETS
NET WORTH
SOURCE OF INCOM E & REGULA R EXPENS
SCHEDUL E A
Cash /Mo n ey Market Funds (attac h additi onal pages if necessary) - Total should ma tch Cash /Money Market Funds above.
Fi na nc i al I nst i tutio n
Type of Account
Account Balance
St atement Date
Continued on page 2.
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