Personal Financial Statement 1 free printable template

Other Loans Policy as Collateral BENEFICIARY C SECURITIES OWNED Face Value-Bonds No. of Shares Stock Indicate those Not Registered in Your Market Value U.S. Gov. Sec. COST D NOTES AND ACCOUNTS RECEIVABLE MAKER/DEBTOR X When Due Description Location Indicate by a X if Others have an Ownership Interest Present Value of Real Date Acquired Original Cost Estate Amount of Ins. Carried F MORTGAGES AND CONTRACTS OWNED Contract Mortgage Maker Name Security if any Amount Pledged to Secured Loans Money...Payable or Owed to You Individually-Indicate by a X if Others have an Ownership Interest Bal. Due Notes Rel. Balance Due Good Doubtful Accounts Accounts Friends TITLE IN NAME OF MARKET VALUE Not Readily Marketable SECURITIES Original Amount E REAL ESTATE OWNED Marketable Sec. MORTGAGE OR CONTRACT PAYABLE Bal. Due Payment Maturity To Whom Payable Maker Address Start Date Property Covered G PERSONAL PROPERTY DESCRIPTION Date When New Cost When New H NOTES Value Today Other than Bank Mortgage and...Insurance Company Loans Other Obligors if any Not Banks PAYABLE TO Payable Contracts Payable For the purpose of procuring credit from time to time I/We furnish the foregoing as a true and accurate statement of my/our financial condition. Authorization is hereby given to the Lender to verify in any manner it deems appropriate any and all items indicated on this statement. CONFIDENTIAL PERSONAL FINANCIAL STATEMENT Statement Date Personal Information Name Address City State Zip Home Telephone SSN...Birthdate Dependents Business Telephone Section I ASSETS Cash on Hand in Banks Cash Value of Life Insurance U.S. Gov. Securities Other Marketable Securities Notes Accounts Receivable - Good Other Assets Readily Convertible to Cash - Itemize TOTAL CURRENT ASSETS Real Estate Owned Mortgages Contracts Owned Notes Due from Relatives Friends Other Securities - Not Readily Marketable Personal Property Other Assets - Itemize TOTAL ASSETS ANNUAL INCOME Salary Bonuses Commissions Dividends Interest...Rental Lease Income Net Other Income - Itemize Other Persons Salary Bonuses Commissions Other Income of Other Person - Itemize Total LIABILITIES Notes Due to Banks Notes Due to Relatives Friends Notes Due to Others Accounts Bills Payable Unpaid Income Taxes Due - Federal State Other Unpaid Taxes Interest Loans on Life Insurance Policies Contract Accounts Payable Cash Rent Owed Other Liabilities Due within 1 Year - Itemize Real Estate Mortgage Payable Liens Assessments Payable Other Debts -...Itemize TOTAL LIABILITIES Net Worth Total Assets - Total Liabilities ESTIMATE OF ANNUAL EXPENSES Income Taxes Other Taxes Insurance Premiums Mortgage Payments Rent Payable Other Expenses GENERAL INFORMATION Are any Assets Pledged No Yes Are you a Defendant in any Suits or Legal Actions Explain Have you ever been declared Bankrupt in the last 10 years CONTINGENT LIABILITIES As Endorser Co-maker or Guarantor- Yes Yes On Leases or Contracts Legal Claims Yes Federal - State Income Taxes Other - A...CASH IN BANKS AND NOTES DUE TO BANKS Name of Bank Type of Account Type of Ownership Cash on Hand TOTALS On Deposit COLLATERAL If any SECTION II Continued B LIFE INSURANCE Company List only those Policies that you own Cash Surrender Value Face of Policy Policy Loan from Insurance Co.