Personal Financial Statement Page 2
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2III.
DEBTS:
(Do not include bills automatically being deducted (any items already listed in
sections I & II Monthly Income & Expenses). List all credit/gas cards and loans: school/home
equity/signature/personal loans, etc.)
Balance
Monthly
Amount
Bank/Institutions/Company/Person
Owed
Payment
Past Due
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
:
TOTAL
$
$
$
=
$
YOUR TOTAL MONTHLY DEBT PAYMENT
IV. ASSETS
(ITEMS PAID IN FULL, TITLES IN YUR NAME, EQUITY IN YUR NAME, ETC.)
Checking Account
$
Savings Account
$
Real Estate/home(s)
$
Vehicle(s), motorcycle(s)
$
Boats (trailers, mobile home)
$
Stocks, bonds, mutual funds, etc.
$
Retirement fund, IRA(s), etc.
$
IV.
DISPOSABLE INCOME
(Add your Monthly Expenses and Debt Payments. Then subtract
that total from our Total Net Income. This final figure will determine your Disposable Income.)
+
Monthly Expenses
$
+
Debt Payments
$
=
Total Monthly Expenses/Debt
$
Total Net Income
$
-
Total Monthly Expenses/Debt
$
=
DISPOSABLE INCOME
$
Privacy Act 5 U.S.C.552 a requires that federal agencies inform whether the disclosure is mandatory or voluntary, by what authority
such information is solicited, and what uses will be made of the information. Authority for soliciting your SSN is Executive Order
9497, Nov.43. Your personal data will be used to identify you precisely when required. Although disclosure is not mandatory, failure
to do so may impede processing.
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