This is to certify that Mr./Ms. [Full Name], son/daughter of [Father’s Name], residing at [Full Residential Address], has a net worth as on [Date], as detailed below. This certificate has been prepared based on the information, documents, and explanations provided by the individual and verified to the extent possible from the relevant records produced before us.
We have relied upon the representations made and declarations submitted by the individual, and wherever possible, supporting documentary evidence has been obtained. Based on the above, we hereby certify the statement of net worth as follows:
Statement of Net Worth as on [Date]
Particulars
Schedule Ref.
Amount (INR)
A. Assets
1. Immovable Properties
Schedule A
₹ [xx,xx,xxx]
2. Movable Properties
Schedule B
₹ [xx,xx,xxx]
3. Bank Balances & Fixed Deposits
Schedule C
₹ [xx,xx,xxx]
4. Investments
Schedule D
₹ [xx,xx,xxx]
5. Insurance Policies (Surrender Value)
Schedule E
₹ [xx,xx,xxx]
6. Other Assets
Schedule F
₹ [xx,xx,xxx]
Total Assets (A)
₹ [xx,xx,xxx]
B. Liabilities
1. Secured Loans
Schedule G
₹ [xx,xx,xxx]
2. Unsecured Loans
Schedule H
₹ [xx,xx,xxx]
3. Other Liabilities
Schedule I
₹ [xx,xx,xxx]
Total Liabilities (B)
₹ [xx,xx,xxx]
Net Worth (A – B)
₹ [xx,xx,xxx]
Schedules to Net Worth Statement
Schedule A – Immovable Properties
Description
Location
Ownership
Estimated Value (INR)
Residential House
[City, State]
Self
₹ [xx,xx,xxx]
Agricultural Land
[Location]
Joint
₹ [xx,xx,xxx]
Commercial Property
[Location]
Self
₹ [xx,xx,xxx]
Total (A)
₹ [xx,xx,xxx]
Schedule B – Movable Properties
Description
Model / Details
Ownership
Estimated Value (INR)
Car – [Brand/Model]
[Year]
Self
₹ [xx,xx,xxx]
Furniture & Fixtures
Home Use
Self
₹ [xx,xx,xxx]
Jewelry
Gold/Diamond
Self
₹ [xx,xx,xxx]
Total (B)
₹ [xx,xx,xxx]
Schedule C – Bank Balances & Fixed Deposits
Bank Name
Account Type
Balance (INR)
[Bank Name]
Savings
₹ [xx,xxx]
[Bank Name]
FD (Maturity)
₹ [xx,xxx]
Total (C)
₹ [xx,xx,xxx]
Schedule D – Investments
Investment Type
Details / Name
Value (INR)
Shares
[Company Name]
₹ [xx,xxx]
Mutual Funds
[Fund Name]
₹ [xx,xxx]
PPF / NSC / Bonds
[Issuer]
₹ [xx,xxx]
Total (D)
₹ [xx,xx,xxx]
Schedule E – Insurance Policies (Surrender Value)
Policy No. / Insurer
Plan Name
Surrender Value (INR)
[Policy No.]
[Plan]
₹ [xx,xxx]
Total (E)
₹ [xx,xx,xxx]
Schedule F – Other Assets
Description
Details
Value (INR)
Advance Paid
For Property
₹ [xx,xxx]
Business Capital
[Name, if any]
₹ [xx,xxx]
Other Receivables
Specify
₹ [xx,xxx]
Total (F)
₹ [xx,xx,xxx]
Schedule G – Secured Loans
Lender Name
Purpose
Outstanding (INR)
[Bank / NBFC Name]
Home Loan
₹ [xx,xxx]
[Bank Name]
Car Loan
₹ [xx,xxx]
Total (G)
₹ [xx,xx,xxx]
Schedule H – Unsecured Loans
Lender Name
Relationship
Outstanding (INR)
[Relative/Entity]
Personal Loan
₹ [xx,xxx]
Credit Card Dues
[Bank Name]
₹ [xx,xxx]
Total (H)
₹ [xx,xx,xxx]
Schedule I – Other Liabilities
Particulars
Description
Amount (INR)
Income Tax Payable
AY [Year]
₹ [xx,xxx]
GST/Other Taxes Payable
If any
₹ [xx,xxx]
Total (I)
₹ [xx,xx,xxx]
This certificate is issued at the request of Mr./Ms. [Name] for the purpose of [Visa Application / Financial Requirement / Credit Appraisal / Tender Application / Other – specify] and is based on the declarations and documents submitted to us.
Place: [City] Date: [DD/MM/YYYY]
For [Name of CA Firm] Chartered Accountants FRN: [Firm Registration Number]
(Signature with Seal) [Name of Chartered Accountant] Proprietor/Partner Membership No.: [XXXXXX] UDIN: [XXXXXXXXXXXXXXXXXX]
