MAKE THE DOCUMENT WORK FOR YOUR SITUATION
About this personal financial statement
Organize assets, liabilities, income, commitments, and supporting records, with an automatically calculated net worth. This editable template brings the key details into one document: statement owner, assets, liabilities & commitments. Complete it online, compare the live preview with your records, and download a blank or completed PDF or editable Word document.
What the template includes
The online builder and downloaded documents use the same fields. A selected state can add relevant research prompts. Complete only applicable items; add explanations for exceptions rather than assuming a blank entry resolves them.
Document details4 inputs +
Set the date, jurisdiction, and your internal reference.
- Document date *
- US state *
- County
- Document reference
Statement owner4 inputs +
This tool requests no account numbers or Social Security number.
- Full name *
- Statement as-of date *
- Statement purpose *
- Valuation basis / assumptions
Assets8 inputs +
Use estimated current values and document the basis.
- Cash and deposits (USD)
- Investments (USD)
- Retirement accounts (USD)
- Real estate (USD)
- Vehicles (USD)
- Business interests (USD)
- Other assets (USD)
- Asset valuation notes
Liabilities & commitments8 inputs +
Include outstanding balances as of the statement date.
- Mortgage debt (USD)
- Other loans (USD)
- Credit card debt (USD)
- Tax liabilities (USD)
- Other liabilities (USD)
- Contingent obligations
- Monthly income (USD)
- Monthly committed expenses (USD)
Additional details & signing7 inputs +
Add attachments, exceptions, and the names of authorized signers.
- Attachments / supporting records
- Exceptions / additional terms
- First signer printed name
- First signer title
- Second signer printed name
- Second signer title
- Signing date
How to complete it
1. Document details
Set the date, jurisdiction, and your internal reference. Review document date, us state, county, document reference against your source records.
2. Statement owner
This tool requests no account numbers or Social Security number. Review full name, statement as-of date, statement purpose, valuation basis / assumptions against your source records.
3. Assets
Use estimated current values and document the basis. Review cash and deposits (usd), investments (usd), retirement accounts (usd), real estate (usd) and the remaining details against your source records.
4. Liabilities & commitments
Include outstanding balances as of the statement date. Review mortgage debt (usd), other loans (usd), credit card debt (usd), tax liabilities (usd) and the remaining details against your source records.
5. Additional details & signing
Add attachments, exceptions, and the names of authorized signers. Review attachments / supporting records, exceptions / additional terms, first signer printed name, first signer title and the remaining details against your source records.
Practical tips
- Be specific. A clear description is easier to verify than a broad label.
- Download Word if you need to add an attachment or adjust the layout.
- Keep the completed document and supporting records together.
Before signing or submitting
A lender or government program may require its own financial statement and certifications. This personal worksheet does not replace SBA Form 413.