个人财务状况

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1、INDIVIDUALFINANCIALSTATEMENT个人财务状况声明ASAT_______________(DATE)截止日_______________________FamilyName:姓：OtherName:名：IdentityCardNo.:身份证号码：PassportNo:护照号码：Date&PlaceofIssue:发行日期：ResidenceAddress:住宅地址：TelephoneNo.:电话号码：BusinessAddress:商业地址：TelephoneNo.:电话号码：OverseasAddressIfAny:海外地址（如有）：TelephoneNo.:

2、电话号码：ProfessionalQualifications(IfApplicable)专业资质（如适用）AnnualIncome年收入Salary工资：__________Others其它：__________Total总共：__________Ifanyofthefollowingassetsarejointlyowned,pleasegivedetails如以下资产是与他人共同拥有，请提供详细资料：Assets资产Amount金额(RMB）CashandDeposits(ScheduleA)现金与存款（A部分）Shares,StocksandBonds(ScheduleB)股

3、份，股票和债券（B部分）RealEstate(ScheduleC)房地产（C部分）AccountsandNotesReceivable(ScheduleD)应收账款或者票据（D部分）OtherPersonalProperty(ScheduleE)其他个人财产(E部分）(includingvehicleetc)包括汽车OtherItems其他其它N.B.AssetsheldthroughthemediumofTrustsshouldNOTbeincludedinthisschedule.不包括由信托中介持有的资产TotalAssets:总资产：Liabilities负债Amount金额

4、(RMB）LoansPayabletoFinancialInstitutions(Schedule1)需要偿还给财务机构的贷款（第一部分）OtherLoansandAccountsPayable(Schedule2)其他贷款和应付账款（第二部分）Mortgages(Schedule3)按揭（第三部分）TaxesPayable应付税务OtherLiabilities其它负债TotalLiabilities:总负债：TotalAsset总资产:_________________Less:TotalLiabilities减总负债:_________________NetWorth净资产:_

5、________________TheinformationcontainedinthisPersonalFinancialStatementiswarrantedasconstitutingafull,trueandcorrectstatementofthefinancialconditionoftheundersigned,andyouwillbenotifiedimmediatelybytheundersignedofanymaterials,adversechangeinthisfinancialcondition.本人保证在该个人财务状况声明中所提供的信息能全面，真实和准确

6、地反映本人的个人财务状况。你会被知会如本人个人财务状况有任何重大或者不利的变化，Name名字:___________________Signature签名:__________________Date日期:__________________GuaranteesIssued担保ToWhom被担保人Reason原因Amount金额ScheduleA(A部分):Assets-CashandDeposits资产–现金或者存款BankorOtherNames银行或其它机构A/CNumber账户号码Amount金额Total总计：ScheduleB(B部分):Assets–Shares,Sto

7、cksandBonds资产-股份，股票和债券Quoted上市：NumberHeld持有数量FaceValue面值WhereListed在何地上市NameofIssue发行人名称CurrentMarketValue现市值Unquoted非上市：Total小计：FullNameofIssue发行人全名CountryofIncorporation注册国家Value价值Total小计：GrandTotal总计：Theinformationcontainedinth