Fillable PERSONAL FINANCIAL STATEMENT

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PERSONAL FINANCIAL STATEMENT

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________________________
PERSONAL FINANCIAL STATEMENT
Prepared for ________________________
on ________________________
NAME:
________________________
ADDRESS:
________________________
________________________, ________________________
________________________
HOME PHONE:
________________________
CELL PHONE:
________________________
SSN:
BIRTHDATE:
________________________
DETAILED SUMMARY LISTING OF ASSETS
INDIVIDUAL ASSET INFORMATION
AMOUNT
Accounts Receivable:
________________________
Annuity:
________________________
Boats:
________________________
Bonds
________________________
Business Property and Real Estate:
________________________
Certificate of Deposit:
________________________
Checking Accounts:
________________________
Household Furnishings:
________________________
Jewelry:
________________________
Life Insurance:
________________________
Mutual Funds:
________________________
Notes Receivable:
________________________
Other Assets:
________________________
Other Real Estate:
________________________
Personal Residence Real Estate:
________________________
Recreational Equipment:
________________________
Retirement Plans:
________________________
Savings Accounts:
________________________
Stocks:
________________________
Trusts:
________________________
Vehicles
________________________
INDIVIDUAL TOTAL ASSET VALUE:
$0.00
DETAILED SUMMARY LISTING OF LIABILITIES
INDIVIDUAL LIABILITY INFORMATION
AMOUNT
________________________
________________________
________________________
________________________
________________________
________________________
________________________
INDIVIDUAL TOTAL LIABILITIES:
$0.00
DETAILED SUMMARY LIST OF MONTHLY INCOME ASSET
INDIVIDUAL MONTHLY INCOME
MONTHLY AMOUNT
Monthly Salary or Wages:
________________________
Investment Accounts:
________________________
Alimony:
________________________
Child Support:
________________________
Trusts:
________________________
Other Income Sources:
________________________
INDIVIDUAL TOTAL MONTHLY INCOME ASSET:
$0.00
DETAILED SUMMARY LIST OF MONTHLY EXPENSE LIABILITY
INDIVIDUAL MONTHLY EXPENSES
MONTHLY AMOUNT
Paid Alimony:
________________________
Paid Child Care:
________________________
Paid Child Support:
________________________
Groceries:
________________________
Healthcare or Medications:
________________________
Housing or Rent:
________________________
Other Mortgage Loans:
________________________
Auto Loans:
________________________
Auto Insurance:
________________________
Health or Dental Insurance:
________________________
Life Insurance:
________________________
Other Insurance:
________________________
Credit Cards:
________________________
Student Loans:
________________________
Other Expenses:
________________________
INDIVIDUAL TOTAL MONTHLY EXPENSE LIABILITY:
$0.00
NET WORTH SUMMARY
TOTAL ASSETS:
$0.00
TOTAL LIABILITIES:
$0.00
TOTAL NET WORTH:
$0.00
I, ________________________, hereby certify and warrant, to the best of my knowledge, that the
aforementioned information contained within this Personal Financial Statement is true, accurate and complete.
DATED: ________________________
________________________
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PERSONAL FINANCIAL STATEMENT

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Completed 24 May 2021

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