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Unformatted text preview: OMB APPROVAL NO. 3245-0188 EXPIRATION DATE: 8/31/2011 PERSONAL FINANCIAL STATEMENT U.S. SMALL BUSINESS ADMINISTRATION As of , Complete this form for: (1) each proprietor, or (2) each limited partner who owns 20% or more interest and each general partner, or (3) each stockholder owning 20% or more of voting stock, or (4) any person or entity providing a guaranty on the loan. Name Business Phone Residence Address Residence Phone City, State, & Zip Code Business Name of Applicant/Borrower ASSETS Cash on hand & in Banks Savings Accounts IRA or Other Retirement Account Accounts & Notes Receivable Life Insurance-Cash Surrender Value Only (Complete Section 8) Stocks and Bonds (Describe in Section 3) Real Estate (Describe in Section 4) Automobile-Present Value Other Personal Property (Describe in Section 5) Other Assets (Describe in Section 5) Total Section 1. Source of Income Salary Net Investment Income Real Estate Income Other Income (Describe below)* Description of Other Income in Section 1....
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