FI-LC-AP-TC-Trust_Company_Application 100 N. 15
Avenue, Suite 261, Phoenix, AZ 85007
Trust Company Application
Personal Financial Statement
Section 7 Page 1 of 4
Do not use for business statement.
Legibly print or type all information.
There must be an answer provided for each question. Therefore, if not applicable use “None” or “N/A”.
Schedules, details and descriptions must be completed in space provided and by attachments if necessary.
Total Assets must equal Total Liabilities and Net Worth.
Describe any unusual assets or liabilities.
Financial Condition As of Date
Address, City, State, Zip
Customer at what financial institution
Cash in other Banks (detail)
Notes payable to Other Banks (detail below)
Ordinary Accounts receivable - Good
Ordinary Accounts Payable
Due from Friends and Relatives (describe)
Due to Friends & Relatives (describe below)
Notes Receivable - Good (Sched 1)
Notes Payable to Others (describe below)
Mortgages Owned (Sched 1)
Readily Marketable Securities (Sched 4)
Automobile Loans or Leases
Other Securities (Sched 4)
Cash Surrender Value of Life Insurance (Sched 5)
Loans on Life Insurance (Sched 5)
Real Estate & Buildings (Sched 2)
Mortgages or Liens on Real Estate (Sched 3)
Other Assets (describe below)
Other Liabilities (describe below)
Net Worth (Assets Minus Liabilities)
Approximate Annual Income and Expense
(exclusive of ordinary living expenses)
Rent or Mortgage Payments
Net Income form Business or Profession
Other (Alimony, child support or separate maint.)
Other (Include alimony, child support or
separate maintenance payments if you are
Are the above evaluations on receivables conservative?
No (If no, explain by separate letter)
Are any assets pledged or debts secured except as indicated?
No (If yes, itemize by debt and security)
Do you have any contingent liabilities for guarantees, endorsements or otherwise?
Do you do business with any other bank?
No (If yes, nature of business)