1. Enter the total value of your 401-k / Retirement Accounts

$

2. What is the estimated value of your automobile(s)?

$

3. Enter the total value of your certificates of deposit

$

4. Enter your current checking account balance

$

5. What is your estimated home value?

$

6. What is your estimated investment property value?

$

7. Enter the total value of your IRA

$

8. Enter the total value of your money market account

$

9. Enter the total value of any other investments

$

10. Enter your current savings account balance

$

11. Enter the total value of your stocks and mutual funds

$

12. How much do you owe on your automobiles?

$

13. How much do you owe on your credit cards?

$

14. How much do you owe on your home equity line of credit?

$

15. How much do you owe in medical bills?

$

16. How much do you owe on your mortgage?

$

17. How much do you owe in outstanding payday loans?

$

18. How much do you owe in personal loans?

$

19. How much do you owe in student loans?

$

20. How much do you owe in title loans?

$

21. How much do you owe in unpaid taxes?

$

22. How much do you owe on any other unsecured debts or loans?

$