Financial Funders Unlimited

SCHEDULES 1-4

PERSONAL ASSETS & LIABILITIES

DATE PREPARED: *

INSTRUCTIONS: PLEASE COMPLETE ALL SCHEDULES. IF ADDITIONAL SPACE IS NEEDED PLEASE USE OTHER LINES ON SHEET.

APPLICANT'S NAME: *

SOCIAL SECURITY #: *

SPOUSE'S NAME:

SOCIAL SECURITY #:

SCHEDULE 1: CASH IN ALL BANKS

NAME OF BANK *

LISTED? * YESNO

MONTHLY INTERST? *

AMOUNT: $ *

ACCOUNT BALANCE? *

CASH IN ALL BANKS TOTAL: $ *

NAME OF PAYER? *

SCHEDULE 2: NOTES DUE YOU

NAME OF PAYER: *

MONTHLY PAYMENT: *

BALANCE DUE *

NOTES DUE YOU TOTAL: $ *

SCHEDULE 3: STOCKS AND BONDS

NAME OF COMPANY *

LISTED? *

#SHARES *

YOUR % *

MONTHLY DIVIDEND *

MARKET VALUE *

PLEDGED? *

STOCKS AND BONDS TOTAL: $ *

SCHEDULE 4: PERSONAL REAL ESTATE OWNED

TYPE OF BLDG, ADDRESS & AGE OF THE PROPERTY *

ORIGINAL COST: $ *

YEAR *

MARKET VALUE OWNERSHIP % *

MORTGAGE BALANCE 1ST, 2ND, 3RD *

RENTAL INCOME? * YESNO

YEAR & MONTHLY AMOUNT

NAME AND ADDRESS OF MORTGAGE HOLDER: *

REAL ESTATE TOTALS $: *

SCHEDULES 5-10

PERSONAL ASSETS & LIABILITIES (CONTINUED)

APPLICANT: *

SPOUSE:

SCHEDULE 5: LIFE INSURANCE

NAME OF COMPANY *

TYPE? *

AMOUNT $: *

BENEFICIARY: *

CASH VALUE $: *

PLEDGED? *

TOTAL LIFE INSURANCE $: *

SCHEDULE 6: PERSONAL/HOUSEHOLD ITEMS

DESCRIPTION:

FURNITURE/APPLIANCES

PLEDGED? *

PRESENT VALUE $: *

ART/JEWELRY/ANTIQUES

PLEDGED? *

PRESENT VALUE $: *

OTHER:

PLEDGED?

PRESENT VALUE $:

PERSONAL ITEMS TOTAL $: *

SCHEDULE 7: CARS & TRUCKS

YEAR, MAKE, MODEL: *

PLEDGED? *

PRESENT VALUE $: *

CARS & TRUCKS TOTAL $: *

SCHEDULE 8: LOANS PAYABLE TO BANKS (EXCLUDING REAL ESTATE LOANS)

NAME AND ADDRESS OF CREDITOR *

PHONE: *

TERM/RATE: *

PAYMENT $: *

BALANCE $: *

COLLATERAL: *

LOANS PAYABLE TO BANKS TOTAL $: *

SCHEDULE 9: TAXES DUE

TYPE OF TAX/YEAR PAST DUE: YEAR: *

MONTHLY $: *

ANNUALLY $: *

CURRENT FED. STATE/PROVIDENCE $: *

MONTHLY $: *

ANNUALLY $: *

PROPERTY TAXES $: *

MONTHLY $: *

ANNUALLY $: *

OTHER $:

MONTLY $:

ANNUALLY $:

TAXES TOTAL $ *

MONTHLY $: *

ANNUALLY $: *

SCHEDULE 10: CREDIT CARDS

CARD TYPE PAYMENT BALANCE DUE

VISA ALL CARDS *

MASTERCARD ALL CARDS *

DEPARTMENT STORES *

OTHER:

CREDIT CARD TOTAL $: *

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