个人财务状况.doc

INDIVIDUAL FINANCIAL STATEMENT个人财务状况声明AS AT _ (DATE)截止日_Family Name:姓：Other Name:名：Identity Card No.:身份证号码：Passport No:护照号码：Date & Place of Issue:发行日期：Residence Address:住宅地址： Telephone No.:电话号码：Business Address:商业地址：Telephone No.:电话号码：Overseas Address If Any:海外地址（如有）：Telephone No.:电话号码：Professional Qualifications (If Applicable)专业资质（如适用）Annual Income 年收入Salary 工资：_Others其它：_Total 总共：_ If any of the following assets are jointly owned, please give details 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）Cash and Deposits (Schedule A)现金与存款（A部分）Shares, Stocks and Bonds (Schedule B)股份，股票和债券（B部分）Real Estate (Schedule C)房地产（C部分）Accounts and Notes Receivable (Schedule D) 应收账款或者票据（D部分）Other Personal Property (Schedule E) 其他个人财产(E部分）(including vehicle etc)包括汽车Other Items 其他其它N.B. Assets held through the medium of Trusts should NOT be included in this schedule.不包括由信托中介持有的资产 Total Assets: 总资产：Liabilities负债Amount金额(RMB）Loans Payable to Financial Institutions (Schedule 1)需要偿还给财务机构的贷款（第一部分）Other Loans and Accounts Payable (Schedule 2)其他贷款和应付账款（第二部分）Mortgages (Schedule 3) 按揭 （第三部分）Taxes Payable 应付税务Other Liabilities 其它负债 Total Liabilities: 总负债： Total Asset总资产 : _ Less: Total Liabilities减总负债 : _ Net Worth净资产 : _The information contained in this Personal Financial Statement is warranted as constituting a full, true and correct statement of the financial condition of the undersigned, and you will be notified immediately by the undersigned of any materials, adverse change in this financial condition.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: _Guarantees Issued 担保To Whom 被担保人Reason原因Amount金额Schedule A (A 部分):Assets - Cash and Deposits 资产 现金或者存款Bank or Other Names 银行或其它机构 A/C Number 账户号码Amount金额 Total 总计：Schedule B (B 部分):Assets Shares, Stocks and Bonds 资产 - 股份，股票和债券Quoted 上市：Number Held持有数量Face Value面值 Where Listed在何地上市 Name of Issue发行人名称Current Market Value现市值Unquoted 非上市： Total 小计： Full Name of Issue 发行人全名Country of Incorporation注册国家Value价值 Total 小计： Grand Total 总计： The information contained in this Personal Financial Statement is warranted as constituting a full, true and correct statement of the financial condition of the undersigned, and you will be notified immediately by the undersigned of any materials, adverse change in this financial condition.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: _Schedule C (C 部分)Assets Real Estate (Properties) 财产 房地产Address 地址Registered Name of Owner(s) 持有人姓名Owned (%)持有比例Cost价格Market Value市场价格 Total 总计：Schedule D (D 部分)Assets Accounts and Notes Receivable财产 应收账款Details 详细资料Due From 应收（人）When Due 到期日Amount 金额 Total 总计：Schedule E (E 部分)Assets Other Personal Property 财产 其它个人资产Details详细资料 (including Vehicles etc) (包括汽车等)Amount (Value) 金额 Total总计：The information contained in this Personal Financial Statement is warranted as constituting a full, true and correct statement of the financial condition of the undersigned, and you will be notified immediately by the undersigned of any materials, adverse change in this financial condition. 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: _Schedule 1 第一部分：Liabilities Loans Payable to Financial Institutions 债务 金融机构应付借款Name and Address of Financial Institution 金融机构名称及地址When Due 到期日 / Repayment Terms 偿还方法Amount Currently Outstanding 即时债务总额 Total总计:Schedule 2 第二部分Liabilities Other Loans and Accounts Payable 债务 其它应付借款Name 名称When Due到期日 / Repayment Terms 偿还方法Amount 金额 Total总计:Schedule 3 第三部分Liabilities Mortgages 债务 抵押Property Address 财产地址When Due 到期日 / Repayment Terms 偿还方法Lending Bank Or Other Person 贷款银行或个人Amount 金额 Total总计:The information contained in this Personal Financial Statement is warranted as constituting a full, true and correct statement of the financial condition of the undersigned, and you will be noti