Personal Financial Statement

Please enter the Application ID and the Primary
Applicant's Social Security Number
in the fields below.
If they are already filled out, please continue the rest.

Application ID
Primary Applicant's Social Security Number--
The Information below is current as of / /


Please complete the Financial Statement below as completely as possible and to
the best of your knowledge, then press the submit button at the bottom of this page.

ASSETS(current value)(Dollars)
LIABILITIES(total balance due)(Dollars)
Cash on hand and in Bank
  
Cash deposit already made
  
Marketable Securities
  
NonMarketable Securities
Credit Cards Payable
Boats/RVs
Notes Payable-Boats/RVs
Autos
Notes Payable-Autos
Real Estate Owned (schedule 1)
Real Estate Mortgages (schedule 2)
Retirement, Pension Fund
Home Equity Loan
OTHER ASSETS(Dollars)
OTHER LIABILITIES(Dollars)
1.
1.
2.
2.
3.
3.
4.
4.
Total Assets
Total Liabilities
  
Net Worth (Assets minus Liabilities)
  
Total (Liabilities plus Net Worth)

Schedule 1 - Real Estate Owned

Location of PropertyFair Market ValueRental IncomePurchase PricePurchase Year
1.
2.
3.
4.
TOTAL 

Schedule 2 - Real Estate Mortgages

To Whom PayableMaturity YearMortgage AmountMortgage Payment
1.
2.
3.
4.
TOTAL 


I authorize Lender to make inquiries as necessary to verify the accuracy of the statements made and to determine my creditworthiness. I certify the above statements are true and accurate as of the stated date above. These statements are made for the purpose of either obtaining a loan or guaranteeing a loan. I understand FALSE statements may result in forfeiture of benefits and possible prosecution by the U.S. Attorney General (Reference 18 U.S.C. 1001).