Step 3: Personal Financial Statement

Thank you for completing the Buyer Profile, please complete the next step – the Personal Financial Statement below.

PERSONAL FINANCIAL STATEMENT STRICTLY CONFIDENTIAL
Horizon Listing Broker's Name*
Name*
First Last
Address Details*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone*
Fax
Email*
Assets
Cash on hand in Banks
U.S. Government Securities
Loans, Notes and Accounts Receivable (what people owe YOU)
Cash Surrender of Life Insurance (not death benefit amount)
Value of Business(es) Presently Owned
Other Stocks and Bonds
Real Estate Owned – Personal Residence (fair market value)
Real Estate Owned – Investment Property (fair market value)
Vehicles: Number Owned (include value of all)
Other Assets:
Liabilities and Net Worth
Notes Payable (amount YOU owe other than real estate loans)
Liens on Real Estate – Personal Residence (amount you still owe)
Liens on Real Estate – Investment Property (amount you still owe)
Vehicle Loan(s)
Sources of Income (per year)
Salary from Present Employment
Dividends and Interest (Income from these per year)
Bonuses and Commissions
Real Estate Income (such as Rental Income)
Other Income:
Signature*
The signature below certifies that the above information is true and correct and acknowledge receipt of the Personal Financial Statement.
Date*
MM slash DD slash YYYY
CAPTCHA

Assets