Personal Financial Statement

	A	C	D	F	H	I	K
1	Personal Financial Statement			DATE:
2
3				PREPARED FOR:			Personal Financial Statement
4							© 2015 Vertex42 LLC
5	APPLICANT			CO-APPLICANT
6							NOTE: This spreadsheet is not meant to be a
7	Full Name:			Full Name:			legal document. Banks and lenders will likely
8	Phone (home):			Phone (home):			have their own forms you need to fill out for loan
9	Phone (work):			Phone (work):			applications. This spreadsheet was designed
10							to help you save information so that completing
11	Current Address			Current Address			the necessary forms will be easier.
12	Street Address:			Street Address:
13	City/State/Zip:			City/State/Zip:			For security reasons, do not save this file with
14	County:			County:			your social security number and date of birth.
15	Since:			Since:			Because this file will include personal financial
16	Own or Rent:	Rent $:		Own or Rent:	Rent $:		data, store this file securely.
17	Previous Address (if less than 5 years at current)			Previous Address (if less than 5 years at current)
18	Street Address:			Street Address:
19	City/State/Zip:			City/State/Zip:
20	County:			County:
21	Since:			Since:
22	Owned or Rented:			Owned or Rented:
23
24	Sensitive Personal Information			Sensitive Personal Information
25	Social Sec. #:			Social Sec. #:
26	Date of Birth:			Date of Birth:
27	# of Dependents:	(include self)		# of Dependents:	(include self)
28	Marital Status:			Marital Status:
29
30	Employment			Employment
31	Current Employer:			Current Employer:
32	Address:			Address:
33	Position/Title:			Position/Title:
34	Since:			Since:
35
36	Previous Employer:			Previous Employer:
37	Address:			Address:
38	Position/Title:			Position/Title:
39	How Long:			How Long:
40
41
42	Certification
43
44	By signing this form, I certify that the information provided in this statement is true and correct.
45
46
47	x			x
48	Applicant Signature		Date	Co-Applicant Signature		Date
49
50