Please
fill out form then print
from your browser and mail or fax. |
KNIGHT
& DAY NEIGHBORHOOD GRILL - FRANCHISES
3684 Lougheed Highway
Vancouver, British Columbia, V5M 2A8
Tel: 604.767.7867 or Fax: 604.299.5128
email: info@knightandday.com |
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PERSONAL FINANCIAL STATEMENT |
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Name
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E-mail
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Address
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Prov
/ State
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PC
/ Zip
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Employer
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Phone
Number
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Occupation
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How
long
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SIN#
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Date
of Birth
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ASSETS AMOUNT LIABILITIES AMOUNT |
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Cash
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Real
Estate
Loans
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Stocks
& Bonds
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Financial
Institutions
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Life
Insurance
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Taxes
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Real
Estate
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Accounts
Payable
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Vehicles
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Other
Liabilities
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Other
Assets
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Total
Liabilities
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Total
Assets
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Total
Net Worth
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SCHEDULE 1: STOCKS & BONDS |
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Description
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Where
Held
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Description
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Where
Held
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SCHEDULE 2: LIFE INSURANCE – NET CSV |
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Insurance
Amount |
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Where
Held
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SCHEDULE 3: REAL ESTATE |
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Address
of Property
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Title
in Name of
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Market Value
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Owing
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Equity
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Mon Pmt
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SCHEDULE 4: VEHICLES |
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Make,
Model, Year
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Market
Value
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SCHEDULE 5: BANK/FINANCIAL INSTITUTION LIABILITIES |
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Bank/Branch
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Phone
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Amount
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Mon Pmt
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Bank/Branch
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Phone
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Amount
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Mon Pmt
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PERSONAL CASH FLOW ANALYSIS
- MONTHLY INCOME AMOUNT MONTHLY
LIABILITIES AMOUNT |
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Salary,
Wages (Monthly Net)
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Rent/Mortgage
(Incl. Utilities)
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Dividends/Interest
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Groceries
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Rental
Income
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Insurance
Premiums
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Business
or Prof. Income
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Loan
Instalments
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Spouse’s
Income (Monthly Net)
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Credit
Cards / Charge Acct
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Other
Assets (Specify)
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General
Living Expenses
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Asset
1
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Auto
(Maintenance . Gas)
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Asset
2
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Other
Expenses (Specify)
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Asset
3
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Expense
1
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Total
Net Income
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Expense
2
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Less
Expense
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Total
Expenses
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Cash
Surplus / <Deficiency>
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| I/We
hereby certify that all information given in this application
and any attachments hereto, is true and correct, and are
made for the purposes of obtaining credit. By signing below,
I/We consent to
and Associates, or its assigns, obtaining form any credit
reporting agency or credit grantor, such information as
it may require at any time in connection with the credit
hereby applied for, and consent to the disclosure at any
time of any information concerning the undersigned to any
credit reporting agency or to any credit grantor with whom
the undersigned has financial relations. |
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Signature
of Applicant
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Date
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Signature
of Applicant
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Date
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Please
fill out form then print
from your browser and mail or fax. |
KNIGHT
& DAY NEIGHBORHOOD GRILL - FRANCHISES
3684 Lougheed Highway
Vancouver, British Columbia, V5M 2A8
Tel: 604.767.7867 or Fax: 604.299.5128
email: info@knightandday.com |
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