Assets and Liabilities Statement Form

July 14, 2011

An assets and liabilities statement form is a statement or a spreadsheet where an individual declares his the various assets and liabilities that he has.

Sample Assets and Liabilities Statement Form:

 

Personal details:

Name: First name ___________ Middle name __________ Surname _____________

Date of birth: __________

Residential address: Street address ____________ City name ____________ State ___________ Zip code _____________

Office address:  Street address ____________ City name ____________ State _____________  Zip code _____________

Home contact number: _____________             Mobile number: _______________

Details of assets:

 

Salary:                                            ___________________

Property valuation:                       ____________________

Investment:                                   ___________________

Fixed deposit:                              ________________

_________________________

Value of total assets:                     _______________

Details of liabilities:

 

Monthly Expenditure:              ________________

Tax paid :                                    ________________

Transport cost:                          ______________

Loan outstanding:                     ________________

Insurance premiums:               _________________

Credit card accounts:                ________________

Utility expenses:                       ________________

Purchase installments:              _________________

Servant’s salary:                      __________________

Groceries:                               _____________________

Children’s clothing and education: _________________

Overdraft in bank:                          _________________

___________________________________

Total valuation of liabilities:              __________________

____________________

Signature of candidate

Dated: _______________

 

Download Assets and Liabilities Statement Form in Word Format

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