Spreadsheet: 02c29a9b-e6a2-4553-9b81-503b6fe807fc
Sheet: Sheet1

Unnamed: 0 | Please Answer Each Question Completely. | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7
 |  |  |  |  |  |  | CONFIDENTIAL
 | Personal Financial Statement
 | Name |  |  |  | Spouses's Name
 | Social Security Number |  |  |  | Social Security Number
 | TX DL# and Expiration |  |  |  | TX DL# and Expiration
 | Address |  |  |  | Business Phone
 |  |  |  |  | Residence Phone
 | City, State, Zip |  |  |  |  | Date of Statement
 | ASSETS | Community Assets & Undersigned's Separate Property | Separate Property of Spouse | LIABILITIES |  | Of Undersigned | Of Spouse
 | Cash on Hand in Banks                                                 (See Schedule A) | $ |  |  | Notes Payable to Banks-Secured                         (See Schedule A)
 | U.S. Gov't Securities & Bonds                              (See Schedule B) |  |  |  | Notes Payable To Banks - Unsecured                 (See Schedule A)
 | Listed Securities                                                      (See Schedule B) |  |  |  | Notes Payable to Relatives                                     (See Schedule A)
 | Retirement Accounts                                            (See Schedule B) |  |  |  | Notes Payable To Others                                          (See Schedule A)
 | Unlisted Securities                                                   (See Schedule C) |  |  |  | Student Loans Payable                                                     (See Schedule A)
 | Real Estate Owned - Homestead                        (See Schedule D) |  |  |  | Balances on Credit Cards & Other Revolving Accounts
 | Other Real Estate Owned                                      (See Schedule D) |  |  |  | Unpaid Taxes
 | Accounts & Notes Receivable                            (List on separate sheet) |  |  |  | Real Estate Mortgages Payable                               (See Schedule D)
 | Automobile (s) |  |  |  | Loans Against Life Insurance
 | Personal Property |  |  |  | Other Debts - Itemize
 | Cash Value - Life Insurance                                (See Schedule E)
 | Other Assets - Itemize
 |  |  |  |  | TOTAL LIABILITIES | 0 | 0
 |  |  |  |  | NET WORTH | 0 | 0
 | TOTAL ASSETS | 0 | 0 |  | TOTAL  LIABILITIES & NET WORTH | 0 | 0
Annual Income/Sources of cash for 20 __ |  | Of Undersigned | Of Spouse |  | Annual Expenditures/Uses of Cash | Of Undersigned | Of Spouse
 | Salary |  |  |  | Mortgage/Rental Payments
 | Bonus/Commission |  |  |  | Installment Payments                                                 (Car Loans, Credit Cards, etc.)
 | Dividends & Interest |  |  |  | Taxes - Federal, State, Local & Real Estate
 | Real Estate Income |  |  |  | Insurance Payments
 | Sale of Assets |  |  |  | Other Expenses (Education, etc.)
 | Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.                                                                    Other income (list) |  |  |  | Total Expenditures/Uses of Cash | 0 | 0
 | Total | 0 | 0 |  | Excess of Income/Sources of Cash over Expenditures/Uses of Cash | 0 | 0
 | General Information
 | Are either you or your spouse a defendant in any legal actions?                  (If yes, please explain on a separate sheet) |  |  |  | Undersigned's marital status
 | Are there presently any judgments, garnishments or attachments?            (If yes, please explain on a separate sheet) |  |  |  | Number of dependents (excluding self & spouse) |  | #
 | Have either you or your spouse ever filed bankruptcy?                                     (If yes, please explain on a separate sheet) |  |  |  | Personal Information
 | Has undersigned executed a separate property agreement? |  |  |  |  | Of Undersigned | Of Spouse
 | Contingent Liabilities                            (If "Yes", See [NAME]) | Of Undersigned | Of Spouse |  | Business or Occupation
 | As [NAME] or Guarantor |  |  |  | Employer
 | On Leases or Contracts |  |  |  | Years with Present Employer
 | Legal Claims |  |  |  | Partner in any other venture(s)
 | Other Special Debts |  |  |  | Date of Birth
 |  |  |  |  |  | Click Here to GoTo Schedule Sheet