AIA Financial Statement

AIA Financial Statement
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
E-mail*
Phone Number*

Area CodePhone Number
1. Cash
Bank
Account Description
Account Balance
Account Title
Bank
Account Description
Account Balance
Account Title
2. Stocks, Mutual Funds, 401k, Iras
Holder of Security
Type of Account
Value
Account Title
Pledged

YesNo
Holder of Security
Type of Account
Value
Account Title
Pledged

YesNo
3. Real Property
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Year Purchased
Purchased Price
Present Market Value
Tax Assessed Value
Mortgage 1
Mortgage 2
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Year Purchased
Purchased Price
Present Market Value
Tax Assessed Value
Mortgage 1
Mortgage 2
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Year Purchased
Purchased Price
Present Market Value
Tax Assessed Value
Mortgage 1
Mortgage 2
4. Vehicles
Owner
Make
Model
Year
Car Loan Amount
Owner
Make
Model
Year
Car Loan Amount
5. Other Assets

Jewelry, gunds, atvs, antiques, personal property, business interests, etc
Asset
Value
Liens
Asset
Value
Liens
Asset
Value
Liens
6. Other Liabilities

Credit Cards, student loans notes, etc
Creditor Name
Account Balance
Creditor Name
Account Balance
Creditor Name
Account Balance
Creditor Name
Account Balance
7. Other
List any other assets or liability
An application must also be filled out in addition to this financial statement: https://form.jotform.com/201494968153160.
Should be Empty:

AIA Financial Statement

1. Cash

2. Stocks, Mutual Funds, 401k, Iras

3. Real Property

4. Vehicles

5. Other Assets

6. Other Liabilities

7. Other