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Personal Financial Statement
DATE:
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PREPARED FOR:
Personal Financial Statement
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© 2015 Vertex42 LLC
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APPLICANT
CO-APPLICANT
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NOTE: This spreadsheet is not meant to be a
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Full Name:Full Name:
legal document. Banks and lenders will likely
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Phone (home):Phone (home):
have their own forms you need to fill out for loan
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Phone (work):Phone (work):
applications. This spreadsheet was designed
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to help you save information so that completing
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Current AddressCurrent Address
the necessary forms will be easier.
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Street Address:Street Address:
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City/State/Zip:City/State/Zip:
For security reasons, do not save this file with
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County:County:
your social security number and date of birth.
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Since:Since:
Because this file will include personal financial
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Own or Rent:Rent $:Own or Rent:Rent $:
data, store this file securely.
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Previous Address (if less than 5 years at current)
Previous Address (if less than 5 years at current)
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Street Address:Street Address:
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City/State/Zip:City/State/Zip:
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County:County:
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Since:Since:
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Owned or Rented:Owned or Rented:
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Sensitive Personal Information
Sensitive Personal Information
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Social Sec. #:Social Sec. #:
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Date of Birth:Date of Birth:
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# of Dependents:
(include self)
# of Dependents:
(include self)
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Marital Status:Marital Status:
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EmploymentEmployment
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Current Employer:Current Employer:
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Address:Address:
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Position/Title:Position/Title:
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Since:Since:
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Previous Employer:Previous Employer:
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Address:Address:
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Position/Title:Position/Title:
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How Long:How Long:
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Certification
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By signing this form, I certify that the information provided in this statement is true and correct.
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Applicant Signature
Date
Co-Applicant Signature
Date
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