CONFIDENTIAL - PLEASE DO NOT LEAVE ANY QUESTIONS UNANSWERED.
For the purpose of procuring and maintaining credit from time to time in any form whatsoever with the above named Bank, for claims and demands against the undersigned, the undersigned submits the following as being a true and accurate statement of his/her financial condition on the following date, and agree that if any change occurs that materially reduces the means or ability of the undersigned to pay all claims or demands against him/her, the undersigned will immediately and without delay notify the said Bank, and unless the Bank is so notified it may continue to rely upon the statement herein given as a true and accurate statement of the financial condition of the undersigned as of the close of business.
The online Personal Financial Statement below contains a "personal information" section, followed by thirteen self-calculating financial schedules. The form will ask you to first complete each schedule. You may move to the next schedule by clicking on the gray "step" button. Once the schedules are completed, the information will automatically download into the final summary.
After completing form go to the file menu and print out
Please contact your banker if you need assistance with completing these schedules. Round all amounts to the nearest $100.
|
Applicant
|
Co-Applicant
|
| Full Name | Full Name |
| Street Address | Street Address |
| City | City |
| State | State |
| Zip | Zip |
| Since | Since |
| Own or Rent | Own or Rent |
| Own Rent | Own Rent |
| Previous Address (if less than 5 years at present) | Previous Address (if less than 5 years at present) |
| City/State/Zip | City/State/Zip |
| Since | Since |
| Owned or Rented | Owned or Rented |
| Own Rent | Own Rent |
| Social Security # (format NNN-NN-NNNN) | Social Security # (format NNN-NN-NNNN) |
| Date of Birth (format NN-NN-NNNN) | Date of Birth (format NN-NN-NNNN) |
| Phone: Residence (format 555-867-5309) | Phone: Residence (format 555-867-5309) |
| Work (format 555-867-5309) | Work (format 555-867-5309) |
| Employer | Employer |
| Address | Address |
| Position/Title | Position/Title |
| Since | Since |
| Dependents/exclude Self | Dependents/exclude Self |
| Annual Income | Applicant | Co-Applicant |
| Salary | ||
| Bonuses/Commissions | ||
| Dividends/Interest | ||
| Net Real Estate Income | ||
| *Other (List) | ||
| *Income
from alimony, child support, or maintenance payments (Need not be entered unless you want it considered as a basis for repayment.) |
||
| Total $ | ||
After completing form go to the file menu and print out
1. Click-here for Savings Account Form
2. Click-here for Securities-Stocks Form
3. Click-here for Life-Insurance Form
4. Click-here for Income-from-Contracts Form
5. Click-here for Real-Estate-Assets Form
6. Click-here for Retirement-Accounts Form
7. Click-here for Installment-Loans-Notes Form
8. Click-here for Credit-Accounts-Debts Form
9. Click-here for Vehicles-Owned Form
10. Click-here for Notes-Due Form
12. Click-here for Other-Assets Form
13. Click-here for Other-Liabilities Form
14. Click-here for Credit-Questions Form