Personal Financial Statement of:
Enter your name here
as of:
mm/dd/yyyy
Assets Amount in Dollars
Cash - checking accounts $ -
Cash - savings accounts -
Certificates of deposit -
Securities - stocks / bonds /
mutual funds -
Notes & contracts receivable -
Life insurance (cash surrender
value) -
Personal property (autos, jewelry,
etc.) -
Retirement Funds (eg. IRAs,
401k) -
Real estate (market value) -
Other assets (specify) -
Other assets (specify) -
Total Assets $ -
Liabilities Amount in Dollars
Current Debt (Credit cards,
Accounts) $ -
Notes payable (describe below) -
Taxes payable -
Real estate mortgages (describe) -
Other liabilities (specify) -
Other liabilities (specify) -
Total Liabilities $ -
Net Worth $ -
Signature: Date:
Notes on Preparation
Note: You may want to print this information to use
as reference later. To delete these instructions, click
the border of this text box and then press the
DELETE key.
Many financial institutions will require information
about your personal financial data. This spreadsheet
will help you prepare a personal financial statement.
Your personal financial statement should show only
your personally held assets and liabilities (debts)
outside the business. Do not include any business
assets or liabilities.
Page 2 of the spreadsheet allows you to give the
details behind the numbers on the balance sheet.
If you present this financial statement to a potential
lender or investor, be sure to sign and date it in the
space provided. The signature is your pledge that the
statement is complete and accurate to the best of
your knowledge.
Step 1: Prepare a list of all assets owned whether
they are paid for or not. Enter the amount you would
receive by selling the asset for cash.
Step 2: Prepare a list of liabilities (money you owe).
Step 3: Net worth = Total Assets - Total Liabilities
Personal Finance Statement of:
Enter your name here
Details
1. ASSETS - Details
Notes and Contracts held
From Whom Owing Balance Owing Original Amount Original Date
Monthly
Payment Maturity Date History / Purpose
$ - $ - $ -
Securities: stocks / bonds / mutual funds
Name of Security
Number of
Shares Cost Market Value
Date of
Acquisition
$ - $ -
Stock in Privately Held Companies
Company Name No. of shares $ Invested
Est. Market
Value
$ - $ -
Real Estate
Description / Location Market Value Amount Owing Original Cost Purchase Date
$ - $ - $ -
2. LIABILITIES - Details
Credit Card & Charge Card Debt
Name of Card / Creditor Amount Due
$ -
Notes Payable (excluding monthly bills)
Name of Creditor Amount Owing Original Amount
Monthly
Payment Interest Rate
Secured by
(Leine)
$ - $ - $ -
Mortgage / Real Estate Loans Payable
Name of Creditor Amount Owing Original Amount
Monthly
Payment Interest Rate
Secured by
(Leine)
$ - $ - $ -
