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Personal Financial Statement Form Template

Streamline Your Financial Reporting with This Easy-to-Use Template

Creating a personal financial statement can feel daunting, especially when you need to present your financial health clearly. This template is designed for individuals looking to efficiently summarize their assets and liabilities, making it easier for you to showcase your financial status. Benefit from time-saving features, a clean and structured layout, WCAG-aligned labels for accessibility, and the flexibility to edit according to your specific needs-all while ensuring a professional presentation. Explore how this template can simplify your financial reporting process.

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Full legal name
Date of birth
Marital status
Single
Married
Domestic partnership or civil union
Separated
Divorced
Widowed
Prefer not to say
Number of dependents
0
1
2
3
4
5+
Email address
Phone number
Current residential address
Housing status
Rent
Own with mortgage
Own free and clear
Live with family
Other
Please Specify:
Employer or business name
Occupation or title
Monthly gross income
Other monthly income before tax (enter 0 if none)
Employment status
Employed full-time
Employed part-time
Self-employed
Unemployed
Student
Retired
Homemaker
Other
Please Specify:
Housing payment (rent or mortgage) per month
Transportation expenses per month
Debt payments per month (loans and credit cards)
Other essential living expenses per month
Cash, checking, and savings total
Investments (stocks, bonds, funds) current value
Retirement accounts (e.g., 401k, IRA) current value
Real estate market value total
Vehicles market value total
Other assets value
Credit card balances total
Installment loans balances total (auto, personal, other)
Student loans balance total
Mortgages and home equity balances total
Other liabilities (including taxes owed) total
Is this a joint statement with a co-applicant?
Yes
No
Are you a party to any lawsuits or judgments?
Yes
No
Have you declared bankruptcy in the past 7 years?
Yes
No
Are any taxes or child support payments past due?
Yes
No
Do you have any contingent liabilities as a guarantor or co-signer?
Yes
No
If you answered Yes to any declaration, provide details
I authorize the recipient to obtain my credit report and verify the information provided
Yes
No
Signature (type full legal name)
Date of signature
I certify that the information provided is true and complete
Yes
No
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paper art illustration depicting a personal financial statement form for financial planning and management

When to use this form

Use this statement when you need a quick, complete snapshot of an individual's finances to make a decision. You might use it for bank or microloan packages, landlord screening, partnership onboarding, franchise applications, and financial planning. As a founder, you can share it with investors to show runway and personal backing. As a lender or property manager, you use it to assess risk, set terms, and speed approvals. If you charge an application or underwriting fee, pair the Credit card authorization form to collect payment securely, or send a Payment request form to invoice first. The outcome: a clear list of assets, debts, income, and expenses you can verify and compare.

Must Ask Personal Financial Statement Questions

  1. What is your employment status and average monthly gross income from all sources?

    This shows stable cash coming in and helps estimate your capacity to repay or meet obligations. Include salary, self-employment, rental income, dividends, and alimony so reviewers see the full picture.

  2. What liquid assets and investments do you hold, with current balances and account types?

    Liquidity signals how quickly you can cover emergencies or a down payment. Account details help reviewers verify your numbers against statements.

  3. What debts do you owe, including balances, interest rates, and required monthly payments?

    Listing liabilities reveals your debt-to-income ratio and overall risk. If you plan to auto-draft payments after approval, you can collect consent with the ACH Authorization form.

  4. What real estate and vehicles do you own, and what are their values, loans, and monthly costs?

    These items can serve as collateral or add costs that affect cash flow. Breaking out each asset prevents double-counting and helps reviewers compare value to debt.

  5. Do you have contingent liabilities, legal obligations, or upcoming changes that could affect your finances?

    Disclosing co-signed loans, guarantees, lawsuits, or job transitions helps avoid surprises. It gives reviewers context to set fair terms or request follow-up documents.

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