| VI. ASSETS AND LIABILITIES |
| This statement and any applicable supporting schedules may
be completed jointly by both married and unmarried Co- borrowers if their assets and
liabilities are sufficiently joined so that the statement can be meaningfully and fairly
presented on a combined basis; otherwise separate Statements and Schedules are required.
If the Co- Borrower section was completed about a spouse, this Statement and supporting
schedules must be completed about that spouse also. |
| |
| |
Completed Jointly
Not Jointly |
| |
| ASSETS |
Cash or Market
Value |
Liabilites and Pledged Assets. List the creditor's
name, address and account number for all outstanding debts, including automobile loans,
revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc.
Use continuation sheet, if necessary. Indicate by (*) those liabilities which will be
satisfied upon sale of real estate owned or upon refinancing of the subject property. |
| |
| Cash deposit toward purchase held by: |
$ |
LIABILITES |
Monthly Pmt. &
Mos. Left to Pay |
Unpaid
Balance |
| |
| List checking and savings accounts below |
|
|
Name & Address of Bank, S&L, or Credit Union
|
Name & Address of Company
|
$ Pat/Mos.
: |
$
- |
| Acct. no. |
$ |
Acct. no. |
|
Name & Address of Bank, S&L, or Credit Union
: |
Name & Address of Company
|
$ Payt./Mos.
: |
$
- |
| Acct. no. |
$ |
Acct. no. |
|
Name & Address of Bank, S&L, or Credit Union
|
Name & Address of Company
|
$ Payt./Mos.
|
$
|
| Acct. no. |
$ |
Acct. no. |
|
Name & Address of Bank, S&L, or Credit Union
|
Name & Address of Company
|
$ Payt./Mos.
|
$
- |
| Acct. no. |
$ |
Acct. no. |
|
Stocks & Bonds(Company name/ number &
description)
|
$
|
Name & Address of Company
|
$ Payt./Mos.
|
$
|
| Acct. no. |
$ |
Acct. no. |
|
Life insurance net cash value
|
. |
Name & Address of Company
|
$ Payt./Mos.
|
$
- |
| Face amount $ |
$ |
Acct. no. |
|
| Subtotal Liquid Assets |
$ |
Name & Address of Company |
$ Payt./Mos. |
$ |
Real Estate owned enter market value from schedule or real estate
owned, (page 3.)
|
$ |
Acct. no. |
|
| Vested interest in retirement fund |
$ |
Name & Address of Company |
$ Payt./Mos. |
$ |
| Net worth of business(es) owned (attach financial statement) |
$ |
Acct. no. |
|
| Automobiles owned (make and year) |
$ |
Alimony/Child Support/Separate Maintenance
Payments |
$ |
. |
Other Assets (itemize)
|
$
|
Job Related Expense (child care, union dues,
etc. )
|
$ |
.
|
| Total Monthly Payments |
$ |
. |
| Total Assets a. |
$ |
Net Worth (a-b) |
$ |
Total Liabilities b. |
$ |