Personal Financial Statement - Mb Financial Bank Page 2
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4BALANCE SHEET AS OF ______________
(Attach and Sign Additional Schedules or Utilize Space as Needed)
Joint
Assets
Applicant
Co-Applicant
Total
Ownership
$
$
$
$
Cash and Short-Term Investments (Schedule A)
Marketable Securities (Schedule B)
Other Liquid Assets
$
$
$
$
Total Liquid/Marketable Assets
Accounts and Notes Receivable (Schedule C)
Real Estate Owned—Personal Residence(s) (Market Value) (Schedule D)
IRA/KEOGH Accounts
Unlisted Securities Owned (Schedule E)
Equity Interest in Business
Real Estate Investments (Market Value) (Schedule F)
General and/or Limited Partnership Interests (Other than Real Estate)
Personal Property
Other Assets (Itemize)
$
$
$
$
Total Assets
Joint
Liabilities
Applicant
Co-Applicant
Total
Ownership
$
$
$
$
Notes Payable — Banks Secured
Notes Payable — Banks Unsecured
Notes Payable — Others
Credit Card Balances
Accounts Payable
Unpaid Income Taxes
Margin Accounts
Mortgages – Residence (Current Mortgage Amount) (Schedule D)
Mortgages – Investments (Amount of Mortgage) (Schedule F)
Other Liabilities (Itemize)
$
$
$
$
Total Liabilities
$
$
$
$
Net Worth (Total Assets Minus Total Liabilities)
Are there any bad and doubtful assets excluded from this statement?
Yes
No
Are any of your assets pledged, loaned or hypothecated?
Yes
No
Are you a partner or officer in any other venture?
Yes
No
Have you ever been bankrupt?
Yes
No
Are any of your assets held in, or owned by, a Living Trust?
Yes
No
If yes to any question, give details___________________________________________________________________________________________________________
*If more than 20% of total assets, attach a current balance sheet and profit and loss statement of the business.
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