This form may ask for sensitive information, such as Social Security numbers, account numbers, income, and health or family details.
DO NOT email your completed form or financial documents. Email is not secure. Send this form with the Submit button below, send documents only through the secure Upload button (Financial International’s SharePoint), or deliver them in person.
This online form sends your answers over an encrypted (HTTPS) connection directly to Financial International.
Only open this form from www.financialinternational.com. Financial International will never email or text you a link asking you to enter your SSN or bank details. If you get one, do not respond; call us at (213) 487-0587.
If you print it, keep the completed form in a safe place and shred spare copies.
Your information is kept confidential and used only to provide the services you asked us for.
Client:
1. Debts
Exclude primary residence mortgage. Enter amounts — totals update live.
Creditor
Min. Monthly Payment
Total Balance Owed
Annual Interest %
Annual Interest Paid $
2. Totals & Ratio
A — Total Minimum Monthly Payments
B — Total Balances Owed
C — Total Annual Interest Paid
After-Tax Monthly Income (for ratio)
D — Debt Payment / After-Tax Monthly Income %
3. Debt Plan
Notes
PROTECTING YOUR INFORMATION
This form may ask for sensitive information, such as Social Security numbers, account numbers, income, and health or family details.
DO NOT email your completed form or financial documents. Email is not secure. Send this form with the Submit button below, send documents only through the secure Upload button (Financial International’s SharePoint), or deliver them in person.
This online form sends your answers over an encrypted (HTTPS) connection directly to Financial International.
Only open this form from www.financialinternational.com. Financial International will never email or text you a link asking you to enter your SSN or bank details. If you get one, do not respond; call us at (213) 487-0587.
If you print it, keep the completed form in a safe place and shred spare copies.
Your information is kept confidential and used only to provide the services you asked us for.
Polished debt mock — live payment/balance/interest totals and ratio.