PERSONAL FINANCIAL STATEMENT
(A) PERSONAL DETAILS
Name (as in NRIC) : NRIC/Passport No. :
Nationality : * Singaporean/Singapore Permanent Resident/Others(please specify) Date of Birth/Age:
Current Residential Address:
Contact Numbers : (Mobile) (Home) (Office/Business) (Fax)
E-mail address :
Marital Status : * Single/Married/Separated/Divorced/Widowed Dependants : (No) (Age)
(B) EMPLOYMENT DETAILS
Current Employer/Business:
Current Office/Business Address :
Date of Employment : Occupation/Position Held:
Monthly Income : (Gross) (Net) Salary Payment Day :
(C) SPOUSE/JOINT BORROWER DETAILS
Name (as in NRIC) : NRIC/Passport No. :
Contact Numbers : (Mobile) (Home) (Office/Business) (Fax)
Residential Address (if different from Borrower):
Current Employer/Business: Occupation/Position Held:
Monthly Income : (Gross) (Net) Date of Birth/Age :
(D) MONTHLY CASH FLOW
Name of Borrower/Spouse/
Joint Borrower
Income
Monthly Net Income
Other Income
Expenses
Utilities - Power Supply
Telephone, Mobile, Internet, etc
Food & Groceries
Transportation
Housing Loan Instalment (Cash)
MC/HDB Conservancy charges
Car Loan Instalment
Total Monthly Car Expenses
(Petrol, Road Tax, etc.)
Income & Property Tax
Maid Salary & Levy
Children & Parents Allowance
Insurance Premium
Others (Please provide details)
Total Monthly Expenses
Income Net of Expenses
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(E) CAUSES OF INDEBTEDNESS (Please tick and provide details, if applicable)
Loss of Income Medical Expenses Deposit for Car/House Loss on Shares/Investments
Income Reduction Heavy Family Commitment Home Renovation Gambling
Loss of Spouse Income Self Education Car Maintenance Over Spending
Business Expense/Failure Children's Education Marriage Expenses Travelling
Payment as Guarantor Loan to Relatives/Friends Divorce Expenses Other Causes
Details:
(F) FINANCIAL LIABILITIES OTHER THAN DBS BANK
Name of Financial Institutions Type of Credit Facilities Amount Owed Security
(G) DBS INSTALMENT REPAYMENT REQUEST
DBS Account No Current Outstanding Monthly Instalment Payment Date
(H) DECLARATION BY BORROWER AND JOINT BORROWER
Declaration to the Bank:
I/We hereby declare that the information given in this Statement is true and correct and that I/we have not wilfully withheld any material fact.
I/We authorise and give you consent to conduct credit checks on me/us (including but not limited to checks with any credit bureau recognised
as such by the Monetary Authority of Singapore) and to obtain and verify and/or to disclose or release any information relating to me/us and/or
any of my/our account(s) with you and from or to any other party or source as you may from time to time deem fit at your own discretion and
without any liability or notice to me/us. I/We understand that the Bank reserves the right to decline my request without giving any reason(s)
whatsoever.
Signature of Main Borrower Signature of Joint Borrower
Name of Main Borrower: Name of Joint Borrower:
NRIC: NRIC:
Date: Date:
This form must be supported by the following documentary evidence:-
I. Proof Of Income (Any of the following)
A. Latest Computerised Pay Slip OR
B. CPF Contribution History
II. Proof of Loan / Obligations With Other Financial Institutions
A. Latest Credit Card, Loan, Overdraft Statement
B. Any other documents to prove obligations
Please reply with the completed signed form and the required supporting documents within SEVEN (7) days from this email.
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