| PERSONAL FINANCIAL STATEMENT |
| [Name] |
|
| [Date] |
|
| |
|
| Assets |
Amount in Dollars |
| Cash - checking accounts |
$ - |
| Cash - savings accounts |
- |
| Certificates of deposit |
- |
| Securities - stocks / bonds / mutual funds |
- |
| Notes & contracts receivable |
- |
| Life insurance (cash surrender value) |
- |
| Personal property (autos, jewelry, etc.) |
- |
| Retirement Funds (eg. IRAs, 401k) |
- |
| Real estate (market value) |
- |
| Other assets (specify) |
- |
| Other assets (specify) |
- |
| Total Assets |
$ - |
| |
|
| Liabilities |
Amount in Dollars |
| Current Debt (Credit cards, Accounts) |
$ - |
| Notes payable (describe below) |
- |
| Taxes payable |
- |
| Real estate mortgages (describe) |
- |
| Other liabilities (specify) |
- |
| Other liabilities (specify) |
- |
| Total Liabilities |
$ - |
| |
|
| Net Worth |
$ - |
| |
|
| |
|
| |
|
| |
|
| |
|
| Signature: |
Date: |
| |
|
