Personal Financial Statement Form - Corning Credit Union
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1
2
3Confidential
Personal Financial Statement as of:
Primary Member Number:
Important: If you are applying for joint credit with another person or using joint assets, you must complete all sections including Section 2.
Both
parties are required to sign.
Section 1 - Individual Information
Section 2 - Other Party Information (Joint Applicant)
Name:
Name:
Address:
Address:
City State & Zip:
City State & Zip:
Phone:
Cell:
Phone:
Cell:
Occupation:
Occupation:
Business Name:
Business Name:
Bus. Address:
Bus. Address:
City State & Zip:
City State & Zip:
Bus. Phone:
Bus. Phone:
Email:
Email:
Section 3 - Statement of Personal Financial Condition (see schedules)
Cash on Hand
Credit Cards:
Other deposits:
Notes and Accounts due to you (collectable)*:
Business inventory*:
Stocks and bonds (detail in schedule B):
Retirement:
(401K)
(IRA)
Business revolving debt:
Other
Bank
Rate
Limit
Machinery & Equipment*:
(personal)
(business)
Automobiles:
Year
Make
Model
Debts owed to banks (detail in schedule C):
Personal
Business
Debt and accounts owed to others (detail in schedule D):
Personal
Business
Real estate mortgages (detail in schedule A):
Cash value of life insurance (details on schedule F):
Lease payments due (list):
Other personal assets (list)*:
Other:
Real Estate owned (see schedule A):
Total Assets:
Total Liabilities:
$
-
$
-
*if over $1,000 itemize in Schedule E
Total Net Worth:
$
-
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