Get documents about "California Separate Property Agreement
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Description
California Separate Property Agreement document sample
Document Sample
Instructions
A. Save this to your PC by going to File…Save As. This must be saved as Excel 97 or 7.0 in order to work properly.
B. Attached are 8 worksheets that pre-fill into the last sheet entitled "Financial Statement - Output".
1. Personal Information
2. Income & Expenses
3. Schedule 1 - Bank Accounts
4. Schedule 2 - Investments (Life Insurance, Retirement, Marketable and Unmarketable securities, etc.)
5. Schedule 3 - Notes Payable (Non-Real Estate)
6. Schedule 4 - Real Estate
7. Assets & Liabilities (several of these fields pre-fill from previous worksheets)
8. Questions
C. Complete,where applicable, the yellow highlighted cells. Cells with a red mark in the upper right hand corner have a "comment" or
"definition" when your mouse pointer passes over the cell.
D. Once you have completed all worksheets, set to print on 2 pages and review the Financial Statement-Output.
E. Read the statement at the bottom then sign and date the form.
F. If you are completing this as part of a loan requirement, please mail or hand deliver the statement to your banking officer.
For security reasons, Do not e-mail the completed financial statement.
G. Contact your banking officer if you have any questions about this form.
PERSONAL PROFILE
Name:
Residential Address:
City / State / Zip: Time at Present Address: (# Years / # Months)
Social Security Number: Date of Birth: (MM/DD/YY)
Housing Info:
Home Phone: (Own, Rent, Other)
Marital Status* No. of Dependents
Employed By: Years: Position: Bus Phone:
Previous Employment: Years: Position: Bus Phone:
SPOUSE'S PROFILE**
Name: Date of Birth: Social Security Number:
Employed By: Years: Position: Bus Phone:
* Married, Unmarried, Separated
** Do not complete the starred (*) sections of this form unless you (a) are a resident of a community property state, (b) are relying on property located
in a community property state as a basis for repayment of the credit requested, or (c) are applying jointly with your spouse for the credit requested.
bc66431d-5d8a-41c4-92f4-a292a3fc7593.xls Personal Information 12/2/2010
ANNUAL INCOME (1) AMOUNT (1) You must check the box on the OUTPUT sheet at line 44 if you are providing a current year
Salary & Wages 0 income tax return complete with all schedules in lieu of completing the above section, "Annual
Spouse's Income* 0 Income". By doing so, you certify that the tax return information is correct and that Red River Bank
may rely upon it as stated below. Note: The Annual Expenditures and Contingent Liabilities sections
Commission, Bonus 0
must still be completed.
Interest, Dividends 0
Gross Rental Income 0
Payments from Notes Receivable 0 (2) Alimony, child support, or separate maintenance income need not be revealed if you do not wish
Alimony/Child Support (2) 0 to have it considered as a basis for repaying this obligation.
Other recurring Income 0
Nonrecurring Income
TOTAL 0
ANNUAL EXPENDITURES AMOUNT CONTINGENT LIABILITIES AMOUNT
Mortgage payments (or Rent) 0 As Endorser 0
Other Real Estate Mortgages 0 As Guarantor 0
Automobile Payments 0 On Damage Claims 0
Other Installment Payments 0 Letter of Credit 0
Alimony/Child Support 0 Other: 0
Credit Card Payments 0 TOTAL 0
Other * taxes 0
Other*
Other*
TOTAL 0
* Place "other" expenditure description under column B in the space provided.
bc66431d-5d8a-41c4-92f4-a292a3fc7593.xls Income & Expenses 12/2/2010
SCHEDULE 1 - (IF YOU USE MORE THAN 6 LINES, PLEASE PRINT THIS PAGE FOR YOUR BANKING OFFICER, AS ONLY 6
LINES WILL TRANSFER TO THE FINAL STATEMENT. THOUGH, ALL WILL BE INCLUDED IN THE DOLLAR TOTALS.).
BANKING RELATIONSHIP (Please list only your personal accounts).
BANK** ACCOUNT NUMBER TYPE OF ACCOUNT BALANCE IS IT PLEDGED?
0
bc66431d-5d8a-41c4-92f4-a292a3fc7593.xls SCHEDULE 1 - Bank Accounts 12/2/2010
SCHEDULE 2 - (NOT ALL LINES OF DATA WILL TRANSFER TO THE FINAL OUTPUT. THOUGH, ALL WILL BE INCLUDED IN THE DOLLAR TOTALS. IF THIS IS
YOUR CASE, THEN PLEASE PRINT AND ATTACH THIS SHEET TO THE FINANCIAL STATEMENT.)
STOCKS AND BONDS (INCLUDING MUTUAL FUNDS)
Note: This is for Liquid investments only, not for Closely Held Companies, IRA,Retirement Funds, Annuities or Life Insurance.
NO. OF MKT VALUE TOTAL MARKET GOV.SECURITY? PLEDEGED? RESTRICTED
ISSUER REGISTERED IN NAME OF WHERE TRADED
SHARES PER SHARE VALUE YES OR NO YES OR NO ? YES OR NO
RETIREMENT ACCOUNTS & ANNUITIES (IRA'S , KEOGH'S, PENSIONS)
NO. OF MKT VALUE TOTAL MARKET PLEDEGED? RESTRICTED
ISSUER REGISTERED IN NAME OF WHERE TRADED
SHARES PER SHARE VALUE YES OR NO ? YES OR NO
CLOSELY HELD COMPANIES (not listed on major stock exchange)
NAME OWNED BY # SHARES % OWNED TOTAL MARKET VALUE
bc66431d-5d8a-41c4-92f4-a292a3fc7593.xls SCHEDULE 2-Investments 12/2/2010
LIFE INSURANCE
TYPE OF POLICY $ LOANS
ISSUER PERSON INSURED OWNER OF POLICY FACE VALUE CASH VALUE
(term, whole,universal) PLEDGED
bc66431d-5d8a-41c4-92f4-a292a3fc7593.xls SCHEDULE 2-Investments 12/2/2010
SCHEDULE 3 - (NOT ALL LINES OF DATA WILL TRANSFER TO THE FINAL OUTPUT. THOUGH, ALL WILL BE
INCLUDED IN THE DOLLAR TOTALS. IF THIS IS YOUR CASE, THEN PLEASE PRINT AND ATTACH THIS SHEET TO THE
FINANCIAL STATEMENT.)
NOTES PAYABLE (EXCLUDING REAL ESTATE MORTGAGES)
COLLATERAL
(If Line of Credit) PAYMENT PAYMENT
DUE TO BALANCE DUE ACCOUNT NO. MATURITY (Automobile, Other- RATE
CREDIT LIMIT AMOUNT FREQ.
Secured, Unsecured)
$ -
Note1: This does not include any debt that you guarantee for your companies.
Note2: The collateral type must be one of the three exactly. I.e. if "vehicle" is used instead of "automobile" it will not subtotal on the final output sheet.
NOTES RECEIVABLE (EXCLUDING REAL ESTATE MORTGAGES)
(If Line of Credit) PAYMENT PAYMENT
DUE FROM BALANCE DUE MATURITY
CREDIT LIMIT AMOUNT FREQ.
bc66431d-5d8a-41c4-92f4-a292a3fc7593.xls SCHEDULE 3-Notes Payable 12/2/2010
$ -
bc66431d-5d8a-41c4-92f4-a292a3fc7593.xls SCHEDULE 3-Notes Payable 12/2/2010
SCHEDULE 4 - (PROVIDE SEPARATE SHEET IF NECESSARY).
REAL ESTATE HOLDINGS
Property Type Includes: Personal Residence, Other Residential, Commercial/Industrial, Partially Owned residential, Partially Owned Commercial
REQUIRED INFORMATION FIRST PROPERTY SECOND PROPERTY THIRD PROPERTY FOURTH PROPERTY FIFTH PROPERTY
Property Type (see above)
Property Address
Cost & Improvements $ - $ - $ - $ -
Estimated Market Value $ - $ - $ - $ -
Mortgage balance $ - $ - $ - $ -
Mortgage Lender/Yr. Purchased
Monthly Principal and Int. Pmts $ - $ - $ - $ -
Interest Rate/Maturity
Annual Gross Rental Income $ - $ - $ - $ -
Annual Cash Operating Expense $ - $ - $ - $ -
Percent of Ownership* 0.00% 0.00% 0.00% 0.00% 0.00%
12/2/2010
bc66431d-5d8a-41c4-92f4-a292a3fc7593.xls SCHEDULE 4 - Real Estate
Note: Some items are prefilled totals from Schedules 1-4. Please check these totals and correct if needed. Then, please complete the remaining items.
FINANCIAL STATEMENT **- List in dollars only. Please attach a separate sheet if further space is needed.
ASSETS LIABILITIES
Cash held at Red River Bank (Schedule 1) 0 Due on Automobiles (Schedule 3) 0
Cash held at Other Institutions (Schedule 1) 0 Notes Payable - Secured (Schedule 3) 0
U.S. Government Securities (Schedule 2) 0 Notes Payable - Unsecured (Schedule 3) 0
Marketable Listed Securities (Schedule 2) 0
Closely Held Companies (Schedule 2) 0 MORTGAGES PAYABLE: (Schedule 4)
Notes & Accounts Receivable 0 Due on Personal Residence 0
Cash Value of Life Insurance 0 Due on Other Owned Real Estate 0
IRA / Keogh's / Pensions 0 Oil and Gas Liablilties
REAL ESTATE (Schedule 4) Revolving Charge Obligations 0
Personal Residence 0 Unpaid Income Taxes 0
Other Owned Real Estate 0 Loans on Life Insurance 0
Oil and Gas Interests Other Liabilities
Automobiles Other Liabilities
Business Equity (other than listed above) TOTAL LIABILITIES (L) 0
Other Assets NET WORTH (NW) = (A-L) 0
TOTAL ASSETS (A) 0 TOTAL (L + NW) 0
** You must check the box on the OUTPUT sheet at line 44 if you are providing a current year income tax return complete with all schedules in lieu of
completing the above section, "Annual Income". By doing so, you certify that the tax return information is correct and that Red River Bank may rely upon it as
stated below. Note: The Annual Expenditures and Contingent Liabilities sections must still be completed.
bc66431d-5d8a-41c4-92f4-a292a3fc7593.xls Assets & Liabilities 12/2/2010
GENERAL INFORMATION* (If married, these questions apply to both you and your spouse). Yes or No
Have you ever had assets repossessed by a creditor?
Have you ever filed bankruptcy or had a judgement against you?
Have you ever been a principal of a firm that declared bankruptcy?
Are you party to any claim or lawsuit?
Are any assets pledged or debts secured except as shown?
What is your total life insurance coverage?
Are any assets held in trust, in estate or in any other name or capacity?
If you answered YES to any of the above, please explain:
Have you been involved in an IRS Audit in the past 3 years?
Results of IRS Audit
Do you have a will/estate plan?
Do you have a separate property agreement?
Have you ever been convicted or plead nolo contendere to a Felony?
What is your disability insurance coverage?
bc66431d-5d8a-41c4-92f4-a292a3fc7593.xls Questions 12/2/2010
RED RIVER BANK Personal Financial Statement
Notice: This statement is designed for use by residents of community property states (Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, or Wisconsin).
This statement should reflect the borrower's financial condition. List all of your separate assets and any community property or income in which you have an interest, as
well as all debts which may be satisfied out of either your separate or community property. If you are seeking credit jointly with your spouse, then include all community
property and separate property on the Personal Financial Statement form. Do not complete the starred (*) sections of this form unless you (a) are a resident of a
community property state, (b) are relying on property located in a community property state as a basis for repayment of the credit requested, or (c) are applying jointly with
your spouse for the credit requested.
Financial Statement Date:
PERSONAL PROFILE
Name: Date of Birth: Social Security Number:
Residence Address: City/State/Zip:
Marital Status* No. of Dependents:
Home Phone Housing Info: Time at Present Address: (# Years / # Months )
Employed By: Years: Position: Bus.Phone:
Previous Employment: Years: Position: Bus.Phone:
SPOUSE'S PROFILE* (see notice above)
Name: Date of Birth: Social Security Number: 000-00-0000
Employed By: Years: Position: Bus.Phone:
FINANCIAL STATEMENT - List in dollars only. Please attach a separate sheet if further space is needed.
ASSETS LIABILITIES
Cash held at Red River Bank (Schedule 1) 0 Due on Automobiles (Schedule 3) 0
Cash held at Other Institutions (Schedule 1) 0 Notes Payable - Secured (Schedule 3) 0
U.S. Government Securities (Schedule 2) 0 Notes Payable - Unsecured (Schedule 3) 0
Marketable Listed Securities (Schedule 2) 0
Closely Held Companies (unlisted)(Schedule 2) 0 MORTGAGES PAYABLE: (Schedule 4)
Notes & Accounts Receivable 0 Due on Personal Residence 0
Cash Value of Life Insurance 0 Due on Other Owned Real Estate 0
IRA/Keogh's/ Pensions 0 Oil and Gas Liablilties 0
REAL ESTATE (Schedule 4) Revolving Charge Obligations 0
Personal Residence 0 Unpaid Income Taxes 0
Other Owned Real Estate 0 Loans on Life Insurance 0
Oil and Gas Interests 0 Other Liabilities 0
Automobiles 0 Other Liabilities 0
Business Equity (other than listed above) 0 TOTAL LIABILITIES (L) 0
Other Assets 0 NET WORTH (NW) = (A-L) 0
TOTAL ASSETS (A) 0 TOTAL (L + NW) 0
ANNUAL INCOME (1) AMOUNT ANNUAL EXPENDITURES AMOUNT CONTINGENT LIABILITIES AMOUNT
Salary & Wages 0 Mortgage payments (or Rent) 0 As Endorser 0
Spouse's Income* 0 Other Real Estate Mortgages 0 As Guarantor 0
Commission, Bonus 0 Automobile Payments 0 On Damage Claims 0
Interest, Dividends 0 Other Installment Payments 0 Letter of Credit 0
Gross Rental Income 0 Alimony/Child Support 0 Other 0 0
Payments from Notes Receivable 0 Credit Card Payments 0 -
Alimony/Child Support (2) 0 Other taxes 0 -
Other recurring Income 0 Other 0 0 -
Nonrecurring Income 0 Other 0 0 -
TOTAL 0 TOTAL 0 TOTAL 0
(1) Check here if you are providing a current year income tax return complete with all schedules in lieu of completing the above section, "Annual
Income". By doing so, you certify that the tax return information is correct and that Red River Bank may rely upon it as stated below. Note: The
Annual Expenditures and Contingent Liabilities sections must still be completed.
(2) Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
GENERAL INFORMATION* (If married, these questions apply to both you and your spouse).
Have you ever had assets repossessed by a creditor? Have you been involved in IRS Audit in the past 3 yrs?
Have you ever filed bankruptcy or had a judgement against you? Results of IRS Audit
Have you ever been a principal of a firm that declared bankruptcy?
Are you party to any claim or lawsuit?
Are any assets pledged or debts secured except as shown? Do you have a will/estate plan?
What is your total life insurance coverage? Do you have a separate property agreement?
Are any assets held in trust, in estate or in any other name or capacity? Have you ever been convicted or plead nolo contendere
If you answered YES to any of the above, please explain: to a Felony?
What is your disability insurance coverage?
For Bank Use Only: Reviewed By:
Date Received: ___/___/___ Direct Account NO.: Indirect Account No,:
SCHEDULE 1 - BANKING RELATIONSHIP (Please provide input sheet if not all records transferred due to space restrictions.)
BANK ACCOUNT NUMBER TYPE OF ACCOUNT BALANCE IS IT PLEDGED?
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
SCHEDULE 2 - INVESTMENTS (Please provide input sheet if not all records transferred due to space restrictions.)
STOCKS AND BONDS (INCLUDING MUTUAL FUNDS)
Note: This is for Liquid investments only, not for Closely Held Companies, IRA,Retirement Funds, Annuities or Life Insurance.
REGISTERED IN NAME NO. OF MKT VALUE TOTAL MARKET PLEDEGED? RESTRICTED?
ISSUER WHERE TRADED
OF SHARES PER SHARE VALUE YES OR NO YES OR NO
0 #VALUE! 0
0 #VALUE! 0
0 0 0 0 $0.00 $0.00 0 0
0 0 0 0 $0.00 $0.00 0 0
0 0 0 0 $0.00 $0.00 0 0
0 0 0 0 $0.00 $0.00 0 0
RETIREMENT ACCOUNTS & ANNUITIES (IRA'S , KEOGH'S, PENSIONS)
REGISTERED IN NAME NO. OF MKT VALUE TOTAL MARKET PLEDEGED? RESTRICTED?
ISSUER WHERE TRADED
OF SHARES PER SHARE VALUE YES OR NO YES OR NO
0
0
0 0 0 $ - $ - $ - 0 0
CLOSELY HELD COMPANIES
NO. OF
NAME OWNED BY TOTAL MARKET VALUE
SHARES % OWNED
0 0 $ - 0.00% $ -
LIFE INSURANCE
TYPE OF POLICY (term, CASH $ LOANS
ISSUER PERSON INSURED OWNER OF POLICY FACE VALUE
whole) VALUE PLEDGED
$ -
SCHEDULE 3 - NOTES PAYABLE (EXCLUDING REAL ESTATE MORTGAGES)
PAYMENT
DUE TO BALANCE ACCOUNT NO. PAYMENT FREQ. MATURITY COLLATERAL RATE
AMOUNT
0
0 0
0 $ - 0 $ - 0 0 0 0.00%
0 $ - 0 $ - 0 0 0 0.00%
0 $ - 0 $ - 0 0 0 0.00%
0 $ - 0 $ - 0 0 0 0.00%
SCHEDULE 4 - REAL ESTATE HOLDINGS - PROVIDE SEPARATE SHEET IF NECESSARY.
Property Type Includes: Personal Residence, Other Residential, Commercial/Industrial, Partially Owned residential, Partially Owned Commercial
REQUIRED INFORMATION FIRST PROPERTY SECOND PROPERTY THIRD PROPERTY FOURTH PROPERTY FIFTH PROPERTY
Property Type (see above) 0
Property Address 0
Cost & Improvements $ - $ - $ - $ - $ -
Estimated Market Value $ - $ - $ - $ - $ -
Mortgage balance $ - $ - $ - $ - $ -
Mortgage Lender/Yr. Purchased 0 0 0 0 0
Monthly Principal and Int. Pmts $ - $ - $ - $ - $ -
Interest Rate/Maturity 0 0 0 0 0
Annual Gross Rental Income $ - $ - $ - $ - $ -
Annual Cash Operating Expense $ - $ - $ - $ - $ -
Percent of Ownership 0.00% 0.00% 0.00% 0.00% 0.00%
For the purpose of obtaining and/or maintaining credit, I submit this financial statement as a true, complete and accurate statement of my financial condition as of the date
hereof and the date of my signature below. I will notify you immediately in the event of any material change in my financial condition, and until such time, you may continue
to rely upon this statement. This statement shall remain your property.
You are authorized to verify the information herein, and obtain such additional information as you may require, by contacting my spouse and other third parties. You may
exchange with, or furnish information to, others regarding your credit experience with me.
Signature of Preparer if other than Borrower:
Signature of Borrower: Date:
Signature of Spouse, if spouse is a joint Co-Borrower: Date:
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