Personal Financial Statement
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1
2PERSONAL FINANCIAL STATEMENT
PREPARED FOR
The Arlington Bank
Name
Business Name
Residence Address
Business Address
Business Phone No.
Residence Phone No.
Business Tax I.D. No.
Social Security No.
Spouse's Name
Date of Birth
Social Security No.
Self Employed: Yes
No
Date of Birth
Position/ Occupation
Position/ Occupation
For how long?
For how long?
ASSETS
LIABILITIES
Date:
MONTHLY
UNPAID
DEPOSITS (Savings, Checking, CD, IRA)
REVOLVING CREDIT
PAYMENT
BALANCE
BANK
TYPE If Joint w/whom?
AMOUNT
MARKETABLE
# OF
$ PER
MONTHLY
UNPAID
SECURITIES
SHARES SHARE
AMOUNT
INSTALLMENT LOANS
PAYMENT BALANCE
NON-MARKETABLE SECURITIES
MONTHLY
UNPAID
UNSECURED LOANS
PAYMENT BALANCE
SUBTOTAL OF ASSETS
$
0
RETIREMENT FUNDS
$
PERSONAL PROPERTY
$
REAL ESTATE LIABILITIES
$
0
CARS/BOATS/RVS (YR., MAKE, MODEL)
VALUE
(SEE SCHEDULE A)
ALIMONY, CHILD SUPPORT, SEPARATE
MONTHLY PMT
$
MAINTENANCE
OTHER DEBTS
MONTHLY
UNPAID
PAYMENT BALANCE
NET WORTH OF BUSINESSES OWNED
(ATTACH FINANCIAL STATEMENT)
$
REAL ESTATE OWNED
$
0
(COMPLETE SCHEDULE A)
TOTAL LIABILITIES
OTHER ASSETS
VALUE
TOTAL MONTHLY PAYMENTS
$
0
TOTAL BALANCES
$
0
TOTAL ASSETS
$
NET WORTH
$
0
0
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Parent category: Financial