Personal Financial Statement
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1
2Personal Financial Statement
Section 1: Applicant Information
Section 2: Co-Applicant
Information*
Name
Name
Date of Birth
Social Security Number
Date of Birth
Social Security Number
Residence Address
Residence Address
City
State
Zip
City
State
Zip
Position/Occupation
Number of Years
Position/Occupation
Number of Years
Employer Name
Employer Name
Residential Telephone
Business Telephone
Residential Telephone
Business Telephone
Nearest Relative Not Living With Me
Relationship
Telephone
Nearest Relative Not Living With Me
Relationship
Telephone
Address
Address
City
State
Zip
City
State
Zip
Driver’s License/ID Number
Expiration Date
Date Issued
State Issued
Driver’s License/ID Number
Expiration Date
Date Issued
State Issued
*When completed and signed denotes your intent to apply for joint credit.
Section 3: Statement of Financial Condition as of
Indicate “A” (Applicant), “C” (Co-Applicant), or “J” (Jointly Held With Others) in column next to assets and liabilities listed to indicate to whom item applies.
ASSETS
A, C or J
Dollar Amount
LIABILITIES
A, C or J
Dollar Amount
Cash on Hand and In Banks (Schedule A)
Secured Notes Payable to Banks (Schedule E)
IRAs, 401(k), Retirement Assets
Unsecured Notes Payable to Banks (Schedule E)
U.S. Gov’t, Marketable Securities (Schedule B)
Due to Brokers, Margin Loans (Schedule E)
Securities Held By Broker in Margin Accounts
Amounts Payable To Others (Secured)
Restricted/Control Stocks (Public Company Only)
Credit Cards (Schedule E)
Real Estate Owned (Schedule C)
Equity Lines (Schedule E)
Loans Receivable
Unpaid Taxes (Income, Property, etc.)
Life Insurance Cash Value (Schedule D)
Real Estate Mortgages Payable (Schedule C)
Value of Closely Held Business
Other Debts (itemize)
Vehicles/Other Personal Property
Other Assets (itemize)
TOTAL LIABILITIES
$0.00
NET WORTH
$0.00
TOTAL ASSETS
$0.00
TOTAL: LIABILITIES AND NET WORTH
$0.00
INCOME FOR YEAR ENDED:
Applicant
Co-Applicant
EXPENSES
Salary
Rent (Payment)
Bonuses and Commissions
Alimony
Interest and Dividends
Child Support
Rental Income
Tuition
PERSONAL INFORMATION (Both Applicant and Co-Applicant)
Other Income (Alimony/child support need not be
revealed if you do not wish to have it considered
Are you a U.S. Citizen?
Yes
No
as a basis for repaying this obligation.)
TOTAL INCOME
$0.00
$0.00
Are you an officer or an immediately family member/dependent
Yes
No
CONTINGENT LIABILITIES
of an officer of a SunTrust Banks, Inc. controlled entity?
Do you have contingent liabilities? If Yes, describe:
Do you have a will?
Yes
No
If Yes
Executor Name:
Are you a partner or officer in another venture?
Yes
No
If Yes,
Describe:
Income tax settled through (date)
Are any assets pledged other than as described on schedules?
Yes
No
If Yes,
As endorser, co-maker or guarantor?
On leases or contracts?
Describe:
Are you a defendant in any suits or legal actions?
Yes
No
If Yes,
Legal claims
Other special debt
Describe:
Amount of contested income tax liens
Have you or your businesses ever been declared bankrupt?
Yes
No
COMPLETE THE SCHEDULES ON THE NEXT PAGE AND PROVIDE SIGNATURE.
317943 (10/08)
Page 1 of 2
SunTrust Corporate Forms
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