Personal Financial Statement
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5PERSONAL FINANCIAL STATEMENT
NAME
AGE
SOCIAL SECURITY NO.
HOME ADDRESS
YRS. THERE
CITY
STATE
ZIP CODE
HOME PHONE
(
)
EMPLOYER
WORK PHONE
(
)
EMPLOYER ADDRESS
CITY
STATE
ZIP CODE
POSITION
YRS. THERE
SOCIAL SECURITY NO.
SPOUSE NAME
AGE
HOME ADDRESS
YEARS THERE
CITY
STATE
ZIP CODE
HOME PHONE
(
)
EMPLOYER
WORK PHONE
(
)
EMPLOYER ADDRESS
CITY
STATE
ZIP CODE
POSITION
YRS. THERE
YOU MAY APPLY FOR CREDIT EXTENSION OR
FINANCIAL ACCOMMODATION SEPARATELY OR JOINTLY
Are you requesting this financial accommodation:
Separately?
Jointly with your spouse?
Jointly with another person: (Please submit
separate financial statements attached together.)
Marital Status (answer only if this financial statement
Married
is provided in connection with a request for secured
Separated
Credit or if you live in a community property state,
Unmarried (unmarried includes
such as California.
single, divorced, widowed)
Reflect in this statement the financial condition of your spouse as well as your own financial condition if:
1.
You are seeking this financial accommodation jointly with your spouse, or
You are relying on your spouse’s assets or income in requesting this financial accommodation, or
2.
3.
You live in a community property state like California
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