State Farm Personal Financial Statement PDF Details

The State Farm Personal Financial Statement form is a crucial document for individuals seeking to outline their financial health comprehensively. Developed by State Farm, a leading insurer and financial services provider, this form serves as a detailed record of an individual’s assets and liabilities, culminating in the calculation of one's net worth. It guides users through the process beginning with the completion of various schedules that capture the financial details of assets such as cash, stocks, real estate, and personal property, along with liabilities including credit card debts, loans, and other payable amounts. By meticulously filling out each specified section and providing the necessary information as instructed, individuals can ensure a thorough and accurate representation of their financial standing. The form emphasizes the importance of starting with the schedules, which are then automatically reflected in the overarching statement, streamlining the process and ensuring consistency in reporting. This structured approach not only simplifies the compilation of complex financial information but also serves as a valuable tool for financial planning and assessment by clearly identifying the monetary value of what one owns versus what one owes.

QuestionAnswer
Form NameState Farm Personal Financial Statement
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namespdffiller personal financial statement, Keogh, state farm personal financial statement form 105896, statefarm

Form Preview Example

statefarm.com/agents/career

Instructions

Personal Financial Statement Instructions

Note: Start with completing the Schedules irst. he totals will carry forward to the Statement. Ater completing ALL applicable sections of the Schedules, please make sure all sections of the Statement are also completed as well.

Schedules

Complete each item as thoroughly as possible and provide all pertinent information requested.

Assets

Assets are things you own that are of monetary value.

·Complete Schedules (1-5) irst, totals will pull forward automatically to Statement.

·Include dollar value/present market value for all items listed as assets.

·“Other Assets” includes anything of monetary value not previously addressed.

·On the Statement, include cash surrender value of life insurance.

·On the Statement, list the number of automobiles owned and the total value of all automobiles.

·On the Statement, include amounts due from others.

·“Total Assets” will calculate automatically.

Liabilities

Liabilities are monies you owe to others.

·Complete Schedules (6-9) irst, totals will pull forward automatically to Statement.

·List outstanding balances on each line item.

·“Other Liabilities” includes any monies you owe to others not previously addressed.

·On Schedule 4, include your mortgage due on real estate/residence.

·On the Statement, include your real estate taxes due.

·On the Statement, include any rents and interest due.

·On the Statement, include any other accounts and notes payable to others.

·“Total Liabilities” will calculate automatically.

Total Net Worth

Total Net Worth is found by subtracting your liabilities from your assets. his will calculate automatically.

This is proprietary information owned by State Farm® and it may be lawfully used only as authorized by appropriate Agency management. 01-04-2011

Z-25204

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Schedules

No. 1 Checking & Savings Accounts (A list of all household checking and savings accounts)

Name and Location

Cash Balance

Checking:

$

 

$

 

 

Savings:

$

 

$

 

 

Total:

$

No. 2 Stocks and Bonds

Description of

Registered in

Cost

Present

Income Rec’d

If Pledged State

Security

Name of

 

Market Value

Last Year

to Whom

 

 

$

$

$

 

 

 

 

 

 

 

 

 

$

$

$

 

 

 

 

 

 

 

 

 

$

$

$

 

 

 

 

 

 

 

 

 

$

$

$

 

 

 

 

 

 

 

 

 

$

$

$

 

 

 

 

 

 

 

 

Total:

$

$

$

 

 

 

 

 

 

 

No. 3 S&T Plan, 401(k), Keogh, etc.

Registered in Name Of

Present Market Value

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

 

$

 

 

Total:

$

No. 4 Real Estate (Solely or partially owned. If partially owned, provide dollar amounts based on percentage owned.)

 

Address / Description

Purchase

 

Purchase

Mortgages

Present

 

Payment

 

 

 

Date

 

Price

or Liens

Market Value

 

Amount

 

 

 

 

$

 

$

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

$

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

$

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

$

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

 

$

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Total:

 

$

 

$

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This is proprietary information owned by State Farm® and it may be lawfully used only as authorized by appropriate Agency management. 01-04-2011

Z-25204

statefarm.com/agents/career

Schedules

No. 5 Other Assets (excluding Auto(s))

Description

Cash Value

$

$

$

$

$

Total: $

No. 6 Credit Card Balance (Credit Cards in your or your spouse’s name)

Credit Card Name

Credit

Current

Monthly

 

limit

Balance

Payment

 

$

$

$

 

 

 

 

 

$

$

$

 

 

 

 

 

$

$

$

 

 

 

 

 

$

$

$

 

 

 

 

 

$

$

$

 

 

 

 

 

$

$

$

 

 

 

 

 

$

$

$

 

 

 

 

 

$

$

$

 

 

 

 

 

$

$

$

 

 

 

 

Total:

$

$

$

No. 7 Notes Payable to Banks (excluding real estate/mortgages) (A list of the amounts owed.)

 

Owed to Whom

Original

Balance

How

Description of Security

 

 

 

 

Amount

Due

Long?

Held

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Total:

$

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This is proprietary information owned by State Farm® and it may be lawfully used only as authorized by appropriate Agency management. 01-04-2011

Z-25204

statefarm.com/agents/career

Schedules

No. 8 Other Liabilities

Description

Cash Value

$

$

$

$

$

Total: $

Completion and submission of this form certiies that the information provided has been carefully reviewed and is true and correct.

This is proprietary information owned by State Farm® and it may be lawfully used only as authorized by appropriate Agency management. 01-04-2011

Z-25204

statefarm.com/agents/career

Personal Financial Statement

Name

To: State Farm Insurance Companies

Address

City

State

Zip

Telephone

Date

Have you or your spouse (if married) ever defaulted on any loan? Y/N

Explain

Do you have an existing interest in any business? Y/N

Explain

Do you have an existing managerial role in any business? Y/N

Explain

Are you or your spouse (if married) the endorser or co-maker of any loans? Y/N

Explain

Are you responsible for any other debt not listed? Y/N

Explain

Assets

 

Liabilities $ Net Worth

 

 

 

 

 

 

Savings & Checking Accounts (Schedule No. 1)

$

Mortgage on Real Estate (Schedule No. 4)

$

 

 

 

 

 

Cash Surrender Value of Life Insurance

$

Real Estate Taxes Due

$

 

 

 

 

 

Stocks & Bonds (Schedule No. 2)

$

Rents & Interest Due

$

 

 

 

 

 

S&T Plan, 401(k), Keogh, etc. (Schedule No. 3)

$

Credit Card Balance (Schedule No. 6)

$

 

 

 

 

 

Real Estate (Schedule No. 4)

$

Notes Payable to Banks (Schedule No. 7)

$

Automobiles – Number/Market Value

 

$

Accounts & Notes Payable to Others

$

 

 

 

 

 

Amounts Due from Others

$

Other Liabilities (Schedule No. 8)

$

 

 

 

 

Other Assets (Schedule No. 5)

$

 

 

 

 

 

 

Total Assets:

$

Total Liabilities:

$

 

 

 

 

 

 

 

 

Total Net Worth:

$

 

 

 

 

 

 

 

 

 

 

This is proprietary information owned by State Farm® and it may be lawfully used only as authorized by appropriate Agency management. 01-04-2011

Z-25204

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how do i get a monthly ira statement from my state farm account spaces to fill in

Write down the details in No Checking Savings Accounts A, Checking, Savings, No Stocks and Bonds, Description of Security, Registered in Name of, Cost, Present Market Value, statefarmcomagentscareer Schedules, Cash Balance, Total, Income Recd Last Year, and If Pledged State to Whom.

how do i get a monthly ira statement from my state farm account No  Checking  Savings Accounts A, Checking, Savings, No  Stocks and Bonds, Description of Security, Registered in Name of, Cost, Present Market Value, statefarmcomagentscareer Schedules, Cash Balance, Total, Income Recd Last Year, and If Pledged State to Whom blanks to complete

Inside the section dealing with Total, No ST Plan k Keogh etc, Registered in Name Of, Present Market Value, Total, No Real Estate Solely or, Mortgages or Liens, Purchase Date, Purchase Price, Address Description, and Present Market Value, one should write down some required information.

Finishing how do i get a monthly ira statement from my state farm account part 3

Spell out the rights and responsibilities of the parties within the paragraph Total, and This is proprietary information.

stage 4 to finishing how do i get a monthly ira statement from my state farm account

End by reading the next areas and preparing them accordingly: statefarmcomagentscareer Schedules, No Other Assets excluding Autos, Description, Cash Value, and Total.

Filling in how do i get a monthly ira statement from my state farm account stage 5

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