Personal Financial Statement

Full name

Prepared by

Date

A lender asks for this because they are looking at you, not only your business, especially when a new business has no track record of its own. It lists what you personally own and owe, and what you personally earn and spend.

Fill in every section as honestly as you can. Leave a line blank or at zero if it does not apply to you.

1. Personal Assets

Everything of value you personally own. Add a line for anything not already listed.

Personal assets, item and amount
Item	Amount	Remove

Total Personal Assets$0.00

2. Personal Liabilities

Everything you personally owe.

Personal liabilities, item and amount
Item	Amount	Remove

Total Personal Liabilities$0.00

3. Annual Income

All the money you personally bring in over a year, from every source.

Annual income, source and amount
Source	Annual Amount	Remove

Total Annual Income$0.00

4. Annual Expenses

What you personally spend over a year, by category.

Annual expenses, category and amount
Category	Annual Amount	Remove

Total Annual Expenses$0.00

5. Contingent Liabilities

Debts you do not owe directly today but could become responsible for, such as a loan you co-signed, a lawsuit against you that is not settled, or taxes being disputed. A lender wants to know about these even though they are not on your regular liabilities list above.

Contingent liabilities, description and amount
Description	Possible Amount	Remove

Total Contingent Liabilities$0.00

Summary

Total Personal Assets$0.00

Total Personal Liabilities$0.00

Net Worth (Assets minus Liabilities)$0.00

Total Annual Income$0.00

Total Annual Expenses$0.00

Annual surplus: $0.00 Your annual income covers your annual expenses.

Signature

Date