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APPLY NOW LOAN TYPES FINANCIAL ANALYSIS INVESTOR REPORTS

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FINANCIAL ANALYSIS FORM

Just let us know a little about yourself financially by filling out the form below and we will have one of our professional financial represetatives contact you after evaluating your information:

Personal Information
Legal Name: Birth Date:
Address:
City:
State: Zip Code:
Email:
Home Phone: Work Phone:
Fax:
Occupation:
Marital Status: Single     Married     Seperated     Divorced


Children
Name:Birth Date:
Name:Birth Date:
Name:Birth Date:


Business Interests
Name of Business:
Type of Entity: C-Corp     LLC     Partnership     S-Corp    
Sole Proprietorship     Other
Describe the Nature/Type of Business:


Income
SourcePersonalSpouseSourcePersonalSpouse
Salary / Wages Social Security
IRA Withdrawls Non-Taxable Income
Tax Exempt Interest Real Estate
Rental Property Dividends
Partnership Revenue Other
 
2005 Gross Taxable Income 2006 Gross Taxable Income
2004 Tax Refund    2005 Tax Refund   
Are you looking for more MONEY making opportunities?   


Debts / Liabilities
Description Current Balance Minimum Payment Interest Rate Months Delinquent
Credit Card %
Credit Card %
Credit Card %
Credit Card %
Line of Credit %
Auto Loan %
Auto Loan %
Student Loan %
Other %
*Mortgage Type Original Balance Current Balance Interest Rate Months Delinquent
1.
2.
Have you or your spouse (if applicable) ever filed for bankruptcy?      What year?  
Out of a total of 100%, what percent of your time is focused on Debt?  %    Wealth?  %
What is your credit score?     What is your spouse's credit score?  


Previous Planning Already Done
Do you or your spouse have ANY of the following?   Living Trust?       Will?


Retirement Assumptions
Desired Monthly After-Tax Retirement Income (in today's dollars) $
Average Annual Inflation Rate


Retirement Assumptions
Source Personal Spouse Source Personal Spouse
401K / 403B Roth IRA
Traditional IRA Pension


Life Insurance
Company Insured Type Death Benefit Cash Value Rate of Return Premium


Goals


Signature(s)
The information in this confidential questionnaire is complete and correct to the best of my / our knowledge. This information can be relied upon in the preparation of tax, business, financial, lawsuit protection, and estate planning suggestions and recommendations.

Your Name
Date
Spouse
Date