Personal Financial Statement

Client(and/or) Entity Name(s)
LIQUID ASSETS:
Checking/Savings Accounts Gross Total:
Mutual Fund and Stocks Accounts Total:
Retirement, IRA, & 401K Vested Total:
NON-LIQUID ASSETS:
Auto's/Boats/Machinery:
Real Estate Total Gross Value:
(# Of Properties Owned)
Private Notes Due IN:
Miscellaneous Other Assets
(Type)
TOTAL ASSETS: +(1)
LIABILITIES:
Credit Card or Unsecured Debt:
Mortgage Loans Outstanding Total:
(# Of Mortgages Owed)
Auto/Boat/Machinery Loans:
Private Notes Owed:
Miscellaneous Other Debt Owed:
(Type)
TOTAL LIABILITIES: -(2)
NET WORTH: = (1 Minus 2)
ESTIMATED ANNUAL INCOME:
Standard Employment Income W-2: (Annual)
Self-Employment Net Income: (Annual)
Real Estate Owned Net Income: (Annual)
Interest and Dividend Income: (Annual)
Other Income: (Explain)
TOTAL ESTIMATED ANNUAL INCOME:
Client Signature
Your Name
Your Name
Your Name
Date

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