statement of personal assets and liabilities

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STATEMENT OF PERSONAL ASSETS AND LIABILITIES
Individual Name:
LIABILITIES
ASSETS
Bank Overdraft:with
Cash at State Bank
Cheque a/c
Savings a/c
Mortgages on Property
To
Monthly Payment $
Freehold Property:
At
owned in Name of:
To
Monthly Payment $
At
owned in Name of:
To
Monthly Payment $
At
owned in Name of:
Rates, Tax provisions etc
Work in Progress &/or Stock in Trade
Trade Creditors
Debtors (Good)
Sundry Loans
Sundry Loans
Owing on Plant and Machinery
to
Plant and Machinery
Owing on Motor Vehicles
Motor Vehicle
Furniture
Other Liabilities:
Other Assets Investments etc:
Total Liabilities
Total Assets
Surplus of Assets over Liabilities
Surplus of Liabilities over Assets
Total $
Total $
I/We declare that the above information is true and correct in every particular and it is upon the basis that I/We
make this application.
Signed for and on behalf of
Date
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