8/21/2019 StatementofAffairs(5) 2 Copy

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Last Name First Name M

NAME

Guarantor TRN

Martial Status

Date of Birth Sex Male Married

/ /

Female Common Law Separated

Home Work Cell

Phone Number 

E-Mail

Last Name First Name M

Guarantor's Relationship to applicant

How Long year months

Own/Rent year months

Previous Address How Long year months

Own/Rent year months

Present Employment How Long year months

Employment address

Occupation/Position How Long year months

Previous Employment How Long year months

How Long year months

How Long year months

MonthDay

Name of Spouse's Place of

Employment

Students Loan BureauStatement of Affairs

Name ofSpouse

PresentAddress

Number ofDependents

 Year 

Single/Divorced/

Widowed

Occupation/Position of

pouse

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8/21/2019 StatementofAffairs(5) 2 Copy

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Date: Signature:

 ______________________________ __________________________________________ 

Witness:

 ____________________________________________ 

JP., Medical Practitioner, Attorney at law

Guarantor Signature

 iabilities

MonthlyPayments(Average)

Approximate BalanceAmount J $

$ $ $

. Do you currently have a savings account (s)? If yes,

please state the current balance and the institution (s) atwhich the funds are being held.

1. Do you have any personal loan (s)

which you are currently repaying? Ifyes, please state the amount currentlyowing, the institution with which you

have said loan and the amount repaidmonthly.

Financial Statement as at ________/________/________ 

(Please complete the sections which apply to you)

 ssets

Approximate Value J $

stocks, bonds or any other financial instruments

Name of Institution (s) *Name of Institution (s) and Purposefor loan

. Are you the holder of any marketable security such as

tocks, bonds or any other financial instruments? If yes,please state please state the value of same and the

nstitution (s) at which the funds are being held.

2. Do you have a mortgage repaying?If yes, please state the amount

currently owing, the institution withwhich you have said loan and the

amount repaid monthly.

. Do you own any property? If yes, please indicate the

ddress, the value and the name of the co-owner if theproperty is jointly owned.

3. Have you rented the property inwhich you reside or contribute to

monthly rental payment? If yes, pleasestate the amount paid each month.

Address & owner (s) Address

. Are you in possession of a motor vehicle which isegistered in your name? If yes, please indicate the year,

model and value of same.

4. Are you the holder of a credit card?If yes, please state the maximum value

of same, the institution with whichyou have said card and the amount

repaid monthly.Year & Model *Institut ion (s)

. Kindly indicate the total value of furniture and

ppliances own by you, if any.

5. Kindly indicate the total value paid

on utilitiesAppliances & Furniture *(eg. Light, water, telephone, etc).

certify the above information to be true and correct. The undersigned consents to the obtaining of such information by the SLB from any credit reporting agency or other source ashe SLB may require at any time in connection with the credit hereby applied for and to the disclosure of any information concerning the undersigned to any credit reporting agency

or to any person with whom the undersigned has or proposes to have financial relations.

Total Total

Surplus/Loss

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