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                 CONFIDENTIAL PERSONAL FINANCIAL STATEMENT
Assets:
Cash on hand and in Banks$______________________________
Saving Accounts  $______________________________
Publicly Traded Securities   $______________________________
Accounts, loans and Notes Receivable      $______________________________
Cash Surrender Value of Life Insurance    $______________________________
Value of Businesses Owned               $______________________________
Automobiles – Number (  )                 $______________________________
Value of Real Estate Owned                     $______________________________
Household Furnishings and Personal Effects    $______________________________
IRA’s and 401K’s                $______________________________
Other Assets (Itemize):    $_______________________________________________
____________________________________________________________________

Total Assets: $______________________________________ 

Liabilities:
Notes Payable                                                   $______________________________
Liens on Real Estate                                $______________________________
Other Liabilities  
(Itemize):                  $_______________________________________________
____________________________________________________________________

Total Liabilities:     $______________________________________ 

Net Worth: (Total Assets minus Total Liabilities)   $____________________________
Sources of Income:         $____________________________
Annual Salary                               $____________________________
Dividends and Interest Income                      $____________________________
Bonuses and Commissions                                   $____________________________ Real Estate Income                                               $____________________________ Other Income (Itemize):    $_______________________________________________
____________________________________________________________________

Total Income: $_______________________________________ 


Affiliated Business Brokers, Inc.
2864 South Circle Drive Ste 540       info@bizsalenow.com      719-527-0858   Office
Colorado Springs, CO 80906                      719-540-9666   Fax
FINANCIAL STATEMENT