Personal Financial Statement Blank Form - Free Download
4.4, 3182 votes
Please vote for this template if it helps you.
Personal Financial Statement Blank Form
Personal Financial Statement Blank Form
OMB APPROVAL NO. 3245-0188
EXPIRATION DATE: 8/31/2011
PERSONAL FINANCIAL STATEMENT
U.S. SMALL BUSINESS ADMINISTRATION
As of ,
Complete this form for: (1) each proprietor, or (2) each limited partner who owns 20% or more interest and each general partner, or (3) each stockholder owning
20% or more of voting stock, or (4) any person or entity providing a guaranty on the loan.
Name
Business Phone
Residence Address Residence Phone
City, State, & Zip Code
Business Name of Applicant/Borrower
ASSETS
Cash on hand & in Banks
Savings Accounts
IRA or Other Retirement Account
Accounts & Notes Receivable
Life Insurance-Cash Surrender Value Only
(Complete Section 8)
Stocks and Bonds
(Describe in Section 3)
Real Estate
(Describe in Section 4)
Automobile-Present Value
Other Personal Property
(Describe in Section 5)
Other Assets
(Describe in Section 5)
Total
Section 1. Source of Income
Salary
Net Investment Income
Real Estate Income
Other Income (Describe below)*
Description of Other Income in Section 1.
(Omit Cents)
LIABILITIES
(Omit Cents)
$
Accounts Payable
$
$
Notes Payable to Banks and Others
$
$
(Describe in Section 2)
$
Installment Account (Auto)
$
$
Mo. Payments
$
Installment Account (Other)
$
$
Mo. Payments
$
Loan on Life Insurance
$
$
Mortgages on Real Estate
$
(Describe in Section 4)
$
Unpaid Taxes
$
$
(Describe in Section 6)
Other Liabilities
$
$
(Describe in Section 7)
Total Liabilities
$
Net Worth
$
$
Total
$
Contingent Liabilities
$
As Endorser or Co-Maker
$
$
Legal Claims & Judgments
$
$
Provision for Federal Income Tax
$
$
Other Special Debt $
*Alimony or child support payments need not be disclosed in "Other Income" unless it is desired to have such payments counted toward total income.
(Use attachments if necessary. Each attachment must be identified as a part of this statement and signed.)
Section 2. Notes Payable to Banks and Others.
Original Current Payment Frequency How Secured or Endorsed
Name and Address of Noteholder(s)
Balance Balance Amount (monthly,etc.) Type of Collateral
SBA Form 413 (10-08) Previous Editions Obsolete (tumble)
This form was electronically produced by Elite Federal Forms, Inc.
Personal Financial Statement Blank Form Previous Page Personal Financial Statement Blank Form Next Page
Personal Financial Statement Blank Form
Previous

1/2

Next