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Personal Financial Statement

Residence

How long at present address

How long with the employer

Relationship status

Personal Data on your spouse

Under the laws of Canada or the provinces your spouse may have a legal interest in your assets

Note: if this section is completed, your spouse must sign in the space provides on the bottom of page 2

How long with the employer?

Financial Information 

ASSETS

List and describe all assets

As At

LIABILITES

List credit cards, open line of credits and other liabilities

(including alimoney and child support)

VALUE

BALANCE OWING

MONTHLY PAYMENT

INCOME SOURCES

Income from alimony, child support or separate maintenance does not have stated unless you want it considered

SCHEDULE B       REAL ESTATE OWNED

Please provide  information on your share of real estate owned

GENERAL INFORMATION

Please provide details if you answer yes to any of the following questions,

Have you ever had an asset repossessed
Have you declared bankrupcy?
Are you oarty to any claims or lawsuits?
Do you owe any taxes prior to current year?

PLEASE READ AND SIGN BELOW

In this agreement “you” means each person who signs below.

You consent to E2E Financial Solutions to obtain credit information and other financially-related information about you at any time from your employer(s), any credit bureau, any registry, any person who has or may have financial dealings with you and any references that you have provided. E2E Financial Solutions may disclose such information about you to any credit bureau, and any person who has or may have financial dealings with you. If there is more than one party to the loan(s) or guarantee which this agreement relates to, E2E Financial Solutions may choose whose information it will disclose to the credit bureau. E2E Financial Solutions will not obtain such information after the loan(s) or guarantee which this agreement relates to has been terminated.

You certify that all information you give to us in this agreement is true, correct and complete.


You confirm having read the terms and conditions above and agree to be bound by them.

Thanks for submitting!