| 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. |
$
|