Financial Statement FormFinancial StatementRequired fields are marked with an asterisk *. You may view the Law of Real Estate Agency here. Your Name*: Your Email Address*: Date: Prepared By: AssetsMonetary Assets1. Cash On Hand: Checking Account: Savings Account: Total Cash: 2. Money Loaned to Others Amount: Date Repayment Expected: 3. Investments Savings Bonds: Stocks and Bonds: Mutual Funds: Surrender Value of Life Insurance: Cash Value of Annuities: Total Investments: 4. Total Monetary Assets Sum of 1, 2, and 3: Fixed Assets5. Home and Property Amount: Address: 6. Other Real Estate Investments Amount: 7. Automobiles Amount: Make & Model: 8. Ownership Interests in Small Businesses Amount: 9. Personal Property Amount: 10. Total Fixed Assets Sum of 5-9: 11. TOTAL ASSETS Sum of 4 and 10: Click here to jump back to top of Financial Statement.Liabilities12. Unpaid Bills Taxes: Insurance Premiums: Rent: Utilities: Charge Accounts: Other: Total Unpaid Bills: 13. Installment Loans (Balance Due) Automobile 1: Automobile 2: Bank Loans: Credit Cards: Educational: Other (Please Describe All Other Loans and Balances Due): Total Installment Loans: 14. Tax Liability Total Tax Liability: 15. Mortgage Loans (Balance Due) Home 1: Home 2: Total Mortgage Loans: 16. TOTAL LIABILITIES Sum of 12, 13, 14 and 15: 17. NET WORTH Subtract 16 from 11: < Return to Tools page.