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FINANCIAL WORKSHEET Loan Number
BORROWER NAME
Name Social Security Number
Name Social Security Number
Home telephone Number Work Telephone Number
ADDRESS INFORMATION
Home Address
Property Address (if different)
EXPENSES
DONATIONS
Church
Other
DUES Union
Club
Other
MEDICAL NOT
COVERED BY INS Doctor/Dentist/Hospital
Drugs
CAR
Gas/Maintenance
Monthly Parking / Tolls
FOOD
Family
School / Work Lunches
CLOTHING
New Clothes / Shoes
Drycleaning
Uniforms / Required Items
Miscellaneous
Spending Money / Entertainment
Cable TV on Phone
Clubs / Sports / Hobbies
Vacations
SAVINGS
Savings Bonds
Credit Union
Bank
TOTAL $0.00
INCOME
DESCRIPTION BORROWER CO-BORROWER TOTAL
Net Salary / Wages $0.00 $0.00 $0.00
Net Overtime Pay
Commissions
Bonuses
TOTAL $0.00 $0.00 $0.00
RECAP
ITEM CURRENT
TOTAL INCOME $0.00
TOTAL EXPENSES $0.00
DIFFERENCE $0.00
ASSETS / LIABILITIES
DESCRIPTION ESTIMATED VALUE AMOUNT OWED NET VALUE
Home $0.00 $0.00 $0.00
Other Property $0.00 $0.00 $0.00
Auto (retail) $0.00 $0.00 $0.00
Auto $0.00 $0.00 $0.00
Bank Accounts $0.00
$0.00 $0.00 $0.00
Boats
Cash Value of Life
Insurance
Collections
Computers
IRA/Keough Accounts
401 K ESOP Accounts
Stocks/Bonds/Cds
Trailers
IRS Liens
Other Investments
Other Investments
I agree that the financial information that I have provided is an accurate statement of
my financial status. I understand and acknowledge that any action taken by the lender
of my mortgage loan upon my behalf will be made in strict reliance to the financial
information provided.
By ______________________________________ ____/_____/____
Signature of Borrower Date
By ______________________________________ ____/_____/____
Signature of Borrower Date
Final Instructions:
1 Review the financial worksheet to make sure that it is correct
2 Make sure you have signed and dated the form.
3 Attach last 2 years federal tax forms
4 Attach last 2 pay stubs for all wages reported.
5 Make copies and of everything and keep them for your records