| Borrower’s monthly NET income: |
$_____________________ |
| Co-Borrower’s monthly NET income: |
$_____________________ |
| Other Income: Please circle below |
$_____________________ |
| (Child support, Alimony, Rental, Other___________________) |
| DOWN PAYMENT TOWARDS DELINQUENCY $_______________ |
| |
| MONTHLY EXPENSES: |
|
Monthly Payments: |
Monthly Payment Balance Owed: |
| Mortgage Payment: |
$______________ |
| Child Care: |
$______________ |
| Alimony/Child Support |
$______________ |
| Telephone: |
$______________ |
| Cell Phone/Pager: |
$______________ |
| Gas/Oil: |
$______________ |
| Electricity: |
$______________ |
| Trash/Sewer: |
$______________ |
| Food: |
$______________ |
| Water: |
$______________ |
| Auto Insurance: |
$______________ |
| Transportation/Gas |
$______________ |
| Life Insurance: |
$______________ |
| Cable/Satellite: |
$______________ |
| Clothing: |
$______________ |
| Prescriptions: |
$______________ | |
| 2nd Mortgage: |
$______________ $______________ |
| Other Mortgage: |
$______________ $______________ |
| Rent Paid: |
$______________ $______________ |
| Doctor Bills: |
$______________ $______________ |
| Hospital Bills: |
$______________ $______________ |
| Auto Loan Pmt: |
$______________ $______________ |
| Auto Loan Pmt: |
$______________ $______________ |
| *Homeowner Ins: |
$______________ $______________ |
| *Property Taxes: |
$______________ $______________ |
| |
| |
|
| *If not included in Mortgage Payment |
| |
|
| |
| | |
| |
| OTHER MONTHLY EXPENSES (Example: Credit Cards, Department Store Cards, IRS Lien): |
| Paid To: Balance: |
Monthly Payment: |
| 1.____________________$_________________ |
$__________________________ |
| 2.____________________$_________________ |
$__________________________ |
| 3.____________________$_________________ |
$__________________________ |
| If more space is necessary, please continue list on additional paper. | |
| |
The information submitted in this personal financial statement is true, correct and complete in all material respects.
The information and documentation provided does not omit any material fact or matter that makes the information
or documentation presented misleading. |
| |
_____________________________________________________________________________________________
Borrower Signature Date Co-Borrower Signature Date |
| |
| |
| revised 4/17/08 |
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