Net Worth Statement
This statement will give you a picture of your current nancial position on a given date and help you determine
your net worth — what you “own” (assets) versus what you “owe” (liabilities). In completing this form, round
gures are sufcient to give you a ballpark idea. This does not have to be an exhaustive review.
Assets
Short Term Assets
Cash on Hand $
Checking Account $
Savings Account $
Savings Bonds $
Money Market Funds $
Certicates of Deposit $
Cash Value (life insurance) $
Total Short Term Assets $
Long Term Assets
Home (market value) $
Mutual Funds $
Tax-Deferred Savings [403(b), IRA, 401(k)] $
Stocks/Bonds $
Certicates of Deposit $
Rental Property $
Equity in Businesses You Own $
Other $
Total Long Term Assets $
Personal Property
Automobiles/Trucks $
Boats/Recreational Vehicles $
Furnishings $
Antiques $
Collectibles (art, stamps, coins) $
Jewelry/Gold/Silver $
Other $
Total Personal Property $
Tot al Assets $
Liabilities
Short Term & Long Term Liabilities
Unpaid Bills $
Credit Cards (balance) $
Principal Residence Mortgage $
Other Mortgages $
Equity Line of Credit $
Education Loans $
Automobile Loans $
Alimony/Child Support $
Personal Loans $
Other $
Total Liabilities $
Net Worth Calculation*
Total Assets $
Total Liabilities – $
Net Worth = $
*N.B. (1) You may want to keep in mind anticipated family gifts or bequests.
(2) If applicable, in completing the questions in the form, you may wish to review marital vs. non-marital assets.
Please note that this document is for informational purposes only and is not intended as investment, tax, nancial, legal or other advice. Your personal decisions
should be based on the recommendations of your own professional advisors. 6/14
