Financial Affidavit Letter

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FINANCIAL AFFIDAVIT LETTER

State of Arizona

County of Page

This is to certify that I, John W. Moberly, having sworn to tell the truth, attest that:
1. I was born on April 10, 1987.
2. I am currently residing at the following address: 4663 Skips Lane, Page, AZ 86040.

EMPLOYMENT

3. My current employment status is as follows:
I am currently NOT EMPLOYED.
I am currently EMPLOYED
Full-time
Part-time
as a Software Developer at WintherTec Inc. located at 732 Nash St., Chicago, IL 60610732 Nash St., Chicago, IL 60610.
I am paid
weekly
monthly
weekly
daily
hourly
other: ________

INCOME

4. The following are my sources of income:
Salary : $ 50,000.00
Bonuses : $ 7,000.00
Incentives : $ 6,000.00
My annual gross income is $ 63,000.00.

DEDUCTIONS

5. The following are my annual deductions:
Federal Income Tax : $ 6,500.00
State Tax : $ 3,000.00
FICA : $ 2,550.00
Bank Loan : $ 5,200.00
My total annual deduction is $ 17,250.00.

6. My net annual income is $ 45,750.00.

EXPENSES

7. The following are my average annual expenses:
Household : $ 5,750.00
Insurance : $ 6,200.00
Transportation : $ 5,400.00
My total average annual expenses is $ 17,350.00.

ASSETS

8. The following are the assets that I currently own:
Cash (in Bank) : $ 204,000.00
Vehicle : $ 20,500.00
Real Estate : $ 180,450.00
The total value of my current assets is $ 404,950.00.

LIABILITIES

9. The following are the liabilities that I currently owe:
Mortgage : $ 12, 450.00
Credit Card : $ 5,700.00
Bills Payable : $ 8, 300.00
The total value of my current liabilities is $ 26,450.00.

10. I certify under penalty of perjury that the above information is complete and correct.

Signature *
John W. Moberly
Name *

NOTARY ACKNOWLEDGEMENT

State of Arizona

County of Page

The foregoing instrument was acknowledged before me this 21st day of June 2035, by the undersigned, who is personally known to me or has satisfactorily proven to me to be the person whose name is subscribed to the within instrument.

Signature *

Jannie M. Riley
Name *

My commission expires on August 23, 2037.