Personal Financial Statement



Assets

Total Assets

Liabilities

Total Liabilities


Net Worth


INCOME

Total Income

SUPPLEMENTARY SCHEDULES OF ASSETS & LIABILITIES

(NOTE: All data listed above must appear in the appropriate schedules. Insert “NONE” where appropriate.)

CASH IN BANKS




NOTES & ACCOUNTS RECEIVABLE




STOCKS/BONDS/SECURITIES




REAL ESTATE




CASH VALUE OF LIFE INSURANCE




OTHER ASSETS




LOANS PAYABLE




ACCOUNTS & NOTES PAYABLE (INCLUDING CHARGE ACCOUNTS)




TAXES PAYABLE (STATE & FEDERAL)




OTHER LIABILITIES