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Loan Application - Assets and Liabilities

Application code: UEQ99UUFQZ

Table of Contents

ASSETS AND LIABILITIES

This statement and any applicable supporting schedules may be completed jointly by both married and unmarried Co-borrowers if their assets and liabilities are sufficiently joined so that the Statement can be meaningfully and fairly presented on a combined basis; otherwise separate Statements and Schedules are required. If the Co-Borrower section was completed about a spouse, this Statement and supporting schedules must be copmleted about that spouse also.

Completed: Jointly Not Jointly

ASSETS	Cash or Market Value
Cash deposit toward purchase held by:	$
List checking and savings accounts below
Name and address of Bank, S&L, or Credit Union
Acct. no.	$
Name and address of Bank, S&L, or Credit Union
Acct. no.	$
Name and address of Bank, S&L, or Credit Union
Acct. no.	$
Name and address of Bank, S&L, or Credit Union
Acct. no.	$
Stocks & Bonds (Company name/number & description):	$
Life insurance net cash value: Face amount: $	$
Subtotal Liquid Assets	$
Real estate owned (enter market value from schedule of real estate owned)	$
Vested interest in retirement fund	$
Net worth of business(es) owned (attach financial statement)	$
Automobiles owned (make and year)	$
Other Assets (itemize)	$
Total Assets a.	$

Liabilities and Pledged Assets. List the creditor's name, address and account number for all outstanding debts, including automobile loans, revolving charge accounts, real estate loans, alimony, child support, stock pledges, etc. Use continuation sheet if necessary. Indicate by (*) those liabilities which will be satisfied upon sale of real estate owned or upon refinancing of the subject property.

LIABILITIES

Monthly Payt. &
Mos. Left to Pay

Unpaid
Balance

Name and address of Company

$ Payt.

Mos.

Acct. no.

Name and address of Company

$ Payt.

Mos.

Acct. no.

Name and address of Company

$ Payt.

Mos.

Acct. no.

Name and address of Company

$ Payt.

Mos.

Acct. no.

Name and address of Company

$ Payt.

Mos.

Acct. no.

Name and address of Company

$ Payt.

Mos.

Acct. no.

Name and address of Company

$ Payt.

Mos.

Acct. no.

Alimony/Child Support/Separate Maintenance Payments
Owed to:

Job Related Expense (child care, union dues, etc.)

Total Monthly Payments

Net Worth (a-b)

Total Liabilities b.

SCHEDULE OF REAL ESTATE OWNED

Property Address enter S if sold, PS if pending sale or R if rental being held for income)	Status	Type of Property	Present Market Value	Amount of Mortgages & Liens	Gross Rental Income	Mortgage Payments	Insurance, Maintenance, Taxes & Misc	Net Rental Income
			$	$	$	$	$	$
			$	$	$	$	$	$
			$	$	$	$	$	$
			$	$	$	$	$	$
			$	$	$	$	$	$
			$	$	$	$	$	$
			$	$	$	$	$	$
			$	$	$	$	$	$
			$	$	$	$	$	$
		Totals	$	$	$	$	$	$

List any additional names under which credit has been received and indicate appropriate name(s) and account number(s):

Alternate Name	Creditor Name	Account Number

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