Personal Financial Statement - Reading Cooperative Bank
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4PERSONAL FINANCIAL STATEMENT AS OF ____________________________
PERSONAL INFORMATION
□
□
Individual
Joint
Information about your spouse need not be provided unless this is a joint statement with your spouse or if you are relying on his or her income or assets to obtain credit.
All parties whose assets are relied upon will be requested to sign notes or other documents required in connection with credit extended.
Name:
Name:
SS#:
DOB:
SS#:
DOB:
Address:
Address:
Home Phone:
Cell Phone:
Home Phone:
Cell Phone:
E-M ail:
E-M ail:
Current Employer & Address:
Current Employer & Address:
Business Phone:
Business Phone:
Title/Position:
# of Years
Title/Position:
# of Years
Previous Employer (if less than 3 years):
# of Years
Previous Employer (if less than 3 years):
# of Years
Accountant Name:
Phone:
Accountant Name:
Phone:
Attorney Name:
Phone:
Attorney Name:
Phone:
PERSONAL BALANCE SHEET
Assets
Amount
Liabilities
Amount
Cash in this Bank
Notes Payable to Banks - Secured (Schedule C)
Cash in other Institutions:
Notes Payable to Banks - Unsecured (Schedule C)
Accounts Payable (including credit cards)
Margin Loans
Loans Against Life Insurnace (Schedule B)
Readily Marketable Securities (Schedule A)
Mortgage Debt (Schedule D)
Non-Readily Marketable Securities (Schedule A)
Contingent Liabilities
Accounts & Notes Receivable
Other Liabilities - List:
Cash Surrender Value Life Insurance (Schedule B)
Real Estate (Schedule D)
Business Partnerships (Schedule E)
IRA, Keogh, Profit Sharing & etc (Schedule F)
Automobile & Personal Property
Other Assets (Schedule G)
Total Assets
Total Liabilities
Total Net Worth
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Personal Financial Statement | Reading Co-operative Bank
12/2013
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Parent category: Financial