Personal Financial Statement

Prepared For: CARE CASH GLOBAL, a California Corporation (“CCG”) — California Finance Lender & Broker

DFPI License No. 60DBO-168236, NMLS Company ID 2353336

Date *

Statement of *

Address

Phone

Email *

Assets

Cash on Hand & Bank Accounts ($)

Stocks & Bonds ($)

Retirement Accounts ($)

Life Insurance Cash Value ($)

Real Estate (Primary Residence) ($)

Other Real Estate ($)

Vehicles ($)

Business Ownership Interests ($)

Accounts Receivable Owed Personally ($)

Other Assets ($)

TOTAL ASSETS ($)

Mortgage Balance ($)

Auto Loans ($)

Credit Cards ($)

Student Loans ($)

Personal Loans ($)

Taxes Payable ($)

Other Liabilities ($)

TOTAL LIABILITIES ($)

Total Assets ($)

Less Total Liabilities ($)

NET WORTH ($)

Salary ($)

Business Income ($)

Investment Income ($)

Rental Income ($)

Other Income ($)

TOTAL ANNUAL INCOME ($)

I certify that the information contained herein is true, complete, and accurate.

Drawn Signature (optional)

Typed Electronic Signature (Full Legal Name) *

Date *

I certify that the information contained in this Personal Financial Statement is true, complete, and accurate.