Personal Financial Statement

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Personal Financial Statement of:

Enter your name here


As of mm/dd/yyyy

Assets Amount in Dollars


Notes on Preparation
Cash - checking accounts $ -
Cash - savings accounts - You may want to print this information to use as reference later. To delete these
Certificates of deposit - instructions, click the border of this text box and then press the DELETE key.
Securities - stocks / bonds / mutual
funds - Many financial institutions will require information about your personal financial data. This
Notes & contracts receivable - spreadsheet will help you prepare a personal financial statement.
Life insurance (cash surrender
value) - Your personal financial statement should show only your personally held assets and
Personal property (autos, jewelry, liabilities (debts) outside the business. Do not include any business assets or liabilities.
etc.) -
Page 2 of the spreadsheet allows you to give the details behind the numbers on the
Retirement Funds (eg. IRAs, 401k) -
balance sheet.
Real estate (market value) - If you present this financial statement to a potential lender or investor, be sure to sign and
Other assets (specify) - date it in the space provided. The signature is your pledge that the statement is complete
Other assets (specify) - and accurate to the best of your knowledge.
Total Assets $ -
Step 1: Prepare a list of all assets owned whether they are paid for or not. Enter the
Liabilities Amount in Dollars amount you would receive by selling the asset for cash.
Current Debt (Credit cards,
Accounts) $ - Step 2: Prepare a list of liabilities (money you owe).
Notes payable (describe below) -
Step 3: Net worth = Total Assets - Total Liabilities
Taxes payable -
Real estate mortgages (describe) -
Other liabilities (specify) -
Other liabilities (specify) -
Total Liabilities $ -

Net Worth $ -

Signature: Date:
Personal Finance Statement of:
Enter your name here
As of mm/dd/yyyy

Details

1. ASSETS - Details

Notes and Contracts held


Monthly
From Whom Owing Balance Owing Original Amount Original Date Payment Maturity Date History / Purpose
$ - $ - $ -

Securities: stocks / bonds / mutual funds


Date of
Name of Security Number of Shares Cost Market Value Acquisition
$ - $ -

Stock in Privately Held Companies


Est. Market
Company Name No. of shares $ Invested Value
$ - $ -

Real Estate
Description / Location Market Value Amount Owing Original Cost Purchase Date
$ - $ - $ -

2. LIABILITIES - Details

Credit Card & Charge Card Debt


Name of Card / Creditor Amount Due
$ -

Notes Payable (excluding monthly bills)


Monthly Secured by
Name of Creditor Amount Owing Original Amount Payment Interest Rate (Leine)
$ - $ - $ -

Mortgage / Real Estate Loans Payable


Monthly Secured by
Name of Creditor Amount Owing Original Amount Payment Interest Rate (Leine)
$ - $ - $ -

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