Key Bank Personal Financial Statement Form PDF Details

When managing personal finances, especially in regards to obtaining or maintaining credit, the Key Bank Personal Financial Statement form stands as a crucial document. This form is designed to provide a detailed and accurate snapshot of an individual's or couple's financial condition at a specific point in time. It requests comprehensive information, including personal details, assets, liabilities, income sources, contingent liabilities, and information on real estate owned, among others. The form also distinguishes between applying for individual credit based on one's own finances or joint credit, where a spouse's or another person's income and assets are considered. The importance of truthfulness when completing this statement cannot be overstated, as inaccuracies can result in significant legal repercussions. This document serves not only as a means for Key Bank to assess financial health but also allows applicants to present a clear picture of their financial status, whether for extension or repayment of credit.

QuestionAnswer
Form NameKey Bank Personal Financial Statement Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other nameskey bank financial statement, keybank statement pdf, bank form personal financial statement keybank, key bank statement pdf

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PERSONAL FINANCIAL STATEMENT

CONFIDENTIAL

To: __________________________________

Address: _____________________________

___________________________________

___________________________________

Personal Financial Statement as of __________________

(DATE)

APPLICANT’S NAME(S): ________________

___________________________________

HOME ADDRESS ______________________

___________________________________

___________________________________

HOME PHONE ________________________

IMPORTANT: DIRECTIONS TO APPLICANT

Read directions before completing Financial Statement.

Please check appropriate box

❏Individual credit—If relying on your own income and assets and not the income and assets of a spouse or another person as a basis for extension or repayment or credit, complete the Financial Statement below only as itapplies to you, individually. Do not provide any information about a spouse or other person. Sign the Financial Statement.

❏ Joint Credit

If applying for joint credit or for individual credit relying

 

on income or assets of a spouse or another person

 

for extension and repayment of credit requested,

❏ Individual relying

complete the Financial Statement below. Include

upon income or

information about income, assets and liabilities of the

assets of spouse

spouse or other person. Both Applicant and Spouse

or other person.

or Co-Applicant sign this statement.

Please do not leave any questions unanswered. Use “no” or “none” where necessary.

 

 

In Even

 

 

 

 

 

 

In Even

Assets

 

Dollars

Liabilities and Net Worth

 

 

 

Dollars

 

 

 

 

 

 

 

 

 

Cash on hand and in Banks—See Schedule A

$

Notes Payable: This Bank—See Schedule A

 

$

U.S. Government Securities—See Schedule B

 

 

Notes Payable: Other Institutions—See

 

 

 

 

Listed Securities—See Schedule B

 

 

Schedule A

 

 

 

 

Unlisted Securities—See Schedule B

 

 

Notes Payable—Relatives

 

 

 

 

Other Equity Interests—See Schedule B

 

 

Notes Payable—Others

 

 

 

 

Accounts and Notes Receivable

 

 

Accounts and Bills Due

 

 

 

 

Real Estate Owned—See Schedule C

 

 

Unpaid Taxes

 

 

 

 

Mortgages and Land Contracts Receivable—

 

 

Real Estate Mortgages Payable—See

 

 

 

 

See Schedule D

 

 

Schedule C or D

 

 

 

 

Cash Value Life Insurance—See Schedule E

 

 

Land Contracts Payable—See Schedule C or D

 

Other Assets: Itemize

 

 

Life Insurance Loans—See Schedule E

 

 

 

 

 

 

 

Other Liabilities: Itemize

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL LIABILITIES

 

 

 

$

 

 

 

NET WORTH

 

 

 

$

TOTAL ASSETS

$

TOTAL LIABILITIES AND NET WORTH

 

$

 

 

 

 

 

 

 

 

 

 

 

 

In Even

 

 

 

 

 

 

 

Sources of Income

 

Dollars

 

General Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Salary

 

$

 

Employer

 

 

 

 

Bonus and Commissions

 

 

 

Position or Profession

 

No. Years

 

 

 

 

 

 

 

 

 

 

Dividends

 

 

 

Employer’s Address

 

 

 

 

 

 

 

 

 

 

 

Real Estate Income

 

 

 

 

 

Phone No.

 

 

 

 

 

 

 

*Other Income: Itemize

 

 

 

Partner, officer or owner in any other venture?

❏ No ❏ Yes

 

 

 

 

If so, explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

$

 

 

 

 

 

 

 

*Alimony, child support or separate maintenance payments need not

 

 

 

 

 

 

 

 

 

 

 

be disclosed unless relied upon as a basis for extension of credit. If

 

Are any assets pledged? ❏ No ❏ Yes

Detail in Schedule A

disclosed, payments received under ❏ court order ❏ written

 

 

 

 

 

 

 

agreement ❏ oral understanding.

 

 

 

Income taxes settled through (Date)

 

 

 

 

 

In Even

 

 

 

Contingent Liabilities

Dollars

General Information (continued)

 

 

 

As endorser, co-maker or guarantor

$

Are you a defendant in any suits or legal action? ❏ No ❏ Yes

On leases

 

If so, explain:

 

 

 

 

 

Legal claims

 

Have you ever taken bankruptcy? ❏ No ❏ Yes

Provision for federal income taxes

 

If so, explain:

 

 

 

 

 

 

 

Other special debt, e.g., recourse or repurchase liability

 

Do you have a will?

❏ No

❏ Yes With whom?

 

 

 

 

 

 

 

Do you have a trust?

❏ No

❏ Yes With whom?

 

 

 

TOTAL

$

Number of dependents ______ Ages _______________

Schedule A: Banks, Brokers, Savings & Loan Association, Finance Companies or Credit Unions. List here the names of all the institutions at which you maintain a deposit account and/or where you have obtained loans.

Name of

Institution

Name on Account

Balance on

Deposit

High Credit

Amount

Owing

Monthly

Secured by

Payment

What Assets

 

 

 

 

TOTAL

TOTAL

Schedule B: U.S. Governments, Stocks (Listed & Unlisted), Bonds (Gov’t & Comm.), and Partnership Interests (General & Ltd.)

Number of

Indicate:

 

 

Pledged

Shares,

1.

Agency or name of company issuing security or name

In Name of

*Market

Yes

No

Face Value

 

of partnership

 

Value

(✓)

(✓)

(Bonds), or

2.

Type of investment or equity classification

 

 

 

 

% of

3.

Number of shares, bonds or % of ownership held

 

 

 

 

Ownership

4.

Basis of valuation*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

*If unlisted security or partnership interest, provide current financial statements to support basis for valuation.

Schedule C: Real Estate Owned (and related debt, if applicable)

Description of

Title in

Property or Address

Name Of

 

 

Date Acq.

Cost +

Improvements

Present

Mkt. Value

Mortgage or Land Contract Payable

Bal. Owing Mo. Payt. Holder

TOTAL

Schedule D: Real Estate: Mortgages & Land Contracts Receivable (and related debt, if applicable)

Description of

Title in

Property or Address

Name Of

Date Acq.

Balance

Receivable

Monthly

Mortgage or Land Contract Payable

Payment

Bal. Owing

Mo. Payt.

Holder

TOTAL

Schedule E: Life Insurance Carried

Name of Company

Face Amount

 

 

Cash Surrender Value

Loans

Beneficiary

TOTAL

I/we have carefully read and submitted the foregoing information provided on all three pages of this statement to the Bank named above. The information is presented as a true and accurate statement of my/our financial condition on the date indicated. This statement is provided for the purpose of obtaining and maintaining credit with said Bank. I/we agree that if any material change(s) occur(s) in my/our financial condition that I/we will immediately notify said Bank of said change(s) and unless said Bank is so notified it may continue to rely upon this financial statement and the representations made herein as a true and accurate statement of my/our financial condition.

I/we authorize the Bank to make whatever credit inquiries it deems necessary in connection with this financial statement. I/we authorize and instruct any person or consumer reporting agency to furnish to the Bank any information that it may have or obtain in response to such credit inquiries.

I/we also hereby certify that no payment requirements listed herein are delinquent or in default except as follows; if “NONE” so state.

I/we fully understand that it is a federal crime punishable by fine or imprisonment or both to knowingly make any false statements concerning any of the above facts, pursuant to 18 U.S.C. Section 1014.

Applicant’s

 

Date

Social

Date of

Signature

_______________________________

Signed ________

Security No. _______

Birth ________

Spouse’s or

 

 

 

Co-Applicant’s

Date

Social

Date of

Signature

_______________________________

Signed ________

Security No. _______

Birth ________

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