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YOUR FINANCIAL / NET WORTH STATEMENT [download to your computer / do not fill out here / Click "File" --> "Download"]
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QUESTIONS / NEED HELP? REACH OUT ANYTIME --> Bill@liftoffcfc.com / 952.900.7557 / liftoffcfc.com
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NameMy Current Employer
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Street AddressPosition/Title
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City Annual Salary
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StateOther Income (Investment, Real Estate, Pension, etc.)
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Zip CodeTotal Annual Income$0.00
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Email Address
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Cell PhoneSpouse/Partner Employer
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Best Times to CallPosition/Title
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Annual Salary
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Marital Status​Other Income (Investment, Real Estate, Pension, etc.)
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Number of DependentsTotal Annual Income$0.00
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Spouse/Partner Name
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My Net Worth Statement
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About My New Franchise Business:Today's date (00.00.0000) -->
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Will you work it full time?​
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Will it be your primary income source?​My Credit Score
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Will your spouse/partner be active in it? ​Spouse/Parner Credit Score
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What role will he/she play?Annual Household Income$0.00
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ASSETSLIABILITIES
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Liquid AssetsShort-Term Liabilities
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Cash On Hand & In BanksCredit Cards
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Savings AccountShort-Term Loans
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Checking AccountOutstanding Taxes
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Money Market FundAccounts Payable
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Certificates of DepositOther
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Treasury Bills & Notes
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Accounts & Notes Receivable
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Life Insurance (cash value)
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Other
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Liquid Assets, Total:$0Short-Term Liabilities, Total:$0
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Investment AssetsLong-Term Liabilties
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Real EstateMortgages
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StocksInvestment Loans
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BondsPersonal Loans
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Mutual FundsStudent Loans
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Business InterestsAuto Loans
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Other Loan(s) Against Life Insurance
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Other
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Investment Assets, Total:$0Long-Term Liabilties, Total:$0
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Retirement Assets
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IRA - Traditional
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IRA - RothMY NET WORTH$0
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401K - TraditionalTotal Assets$0
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401K - RothTotal Liabilities$0
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Keogh
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PensionMy Liquidity$0
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Other
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Retirement Assets, Total:$0
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Personal Assets (market value)
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Primary Residence
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Vacation Properties
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Cars
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Boats
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Home Furnishings
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Art / Jewelry / Collectibles
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Other
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Personal Assets, Total:$0
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