Personal Financial Statement Form Page 2
ADVERTISEMENT
1
2SCHEDULE A. REAL ESTATE RESIDENCE (Title to all real estate listed is in my name solely and unencumbered, except as noted)
Location and
Title Held in
Date
Original
Market
Monthly
Balance of
Loan
To Whom Estate is
Description:
Name of:
Acquired:
Purch Price:
Value:
Payment:
Mortgage:
Number:
Payable To:
SCHEDULE B. LIFE INSURANCE
Company
Agent
Policy
Amount of
Cash
Loan Against
Beneficiary:
To Whom Policy is
Name:
Name:
Number:
Policy:
Value:
Policy:
Assigned:
SCHEDULE C. LOAN'S PAYABLE
Name & Address of
Loan
Original
Current
Terms of
Maturity
Description of Assets Pledged:
Holder/Note:
Number:
Loan Amt:
Balance:
Repayment:
Date:
GENERAL INFORMATION
The assets listed in this statement which are pledged include:____________________________________________________________
Partnership in any hui, joint venture or partnership include:______________________________________________________________
All Federal, State income taxes, real estate gross income, withholding taxes are paid except (name & amount):_____________________
Legal action against me/us include:_________________________________________________________________________________
Personal Bankruptcy was filed (date and details): _____________________________________________________________________
References where other credit has been obtained: ___________________________________________________________________
Personal References: ___________________________________________________________________________________________
The information contained in this Statement is provided for the purpose of obtaining, or maintaining credit with you on behalf of the u
undersigned or persons, partnerships, or corporations on whose behalf the undersigned may, either individually, or jointly and severally
with others, execute a guaranty in your favor. Each undersigned understands that you are relying on the information provided herein
(including the designation made as to ownership of property) in deciding to grant or continue credit. Each undersigned represents and
warrants that the information provided is true and complete and that you may consider this Statement as continuing to be true and
correct until a written notice of a change is given to you by the undersigned. You are authorized to make all inquiries you deem
necessary to verify the accuracy of the statements made here, and to determine my/our creditworthiness.
________________________________________________________
____________________________________________________
Borrower Signature:
Date:
Borrower Signature:
Date:
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial