INCOME

(weekly, bi-weekly 2x month)

(weekly, bi-weekly 2x month)

Out sources of income

DEPENDENTS IN HOUSEHOLD

EXPENSES (monthly averages)

Housing

Utilities

Phone

Insurance

Taxes

Installment Payments

Misc Expenses

If less than 3 years, list all addresses for past 3 years

TAXES RETURNS

CASH ADVANCES

Have you taken any cash advances from Credit cards in the last 12 months? If Yes

BUSINESS OWNED IN LAST 6 YEARS

REAL ESTATE

How much is owed on the Property? 

How much is owed on the Property? 

How much is owed on the Property? 

Have you owned any other real estate in the last 10 years?

VEHICLES/ MOTORCYCLES/ RV'S/ MOBILE HOMES

HOBBY EQUIPMENT/TOYS

Please list: boats, canoes, 4 wheelers, Motorcycles,  trailers

BANK ACCOUNT

Do you have a Health Savings or Flex Spending Account?

Property owned by you- the Value of your Property is what you could sell it for in a yard sale, garage sale or pawn shop. Do not use the retail cost to replace or what you paid for an item.

Property owned

Electronics

Collectables - coins, art, stamps

Furs and Jewelry

Guns

Sports equipment

Retirement Debtor # 1

Retirement Debtor # 2

Stocks and Bonds

Investment Accounts

Pending Claims

Tool used for Work

Household tools

Security Deposits

Schedule of Depts: 

It is important to have a complete list of all bills and creditors, even the depts you intend to keep such as mortgage or car loan. You will be required to bring us copies of all yours bills. We will be pulling all of your credit reports but is your responsibility to make sure all of your creditors are listed.       Breakdown of Debts:

STATEMENT OF FINANCIAL AFFAIRS 

Please answer all questions completely and honestly. If it does not apply to you please answer N/A.

BUSINESS OWNERS QUESTIONS