FIRST BANK OF MANHATTAN MORTGAGE LOAN ORIGINATORS NMLS ID #405508

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1 ITEMS TO BE SUBMITTED WITH HOME EQUITY LOAN APPLICATION Bring In: Pay stubs from the ast 30 days W-2 s and Tax Returns from the ast 2 years Bank Statements from ast 2 months (A Pages) Copy of Homeowner s Insurance Poicy Copy of most recent Rea Estate Tax Bi Information on existing mortgage(s) (Refinance Ony) Fi Out & Sign: Appication Request for Information for Government Monitoring Purposes Borrower s Certification and Authorization Servicing Discosure Statement Appraisa Deivery Waiver Property Description Sheet ************************************************************************************** FIRST BANK OF MANHATTAN MORTGAGE LOAN ORIGINATORS NMLS ID # Angea K. Brandau, Vice President NMLS ID # John E. Kramer, President NMLS ID # David S. Zang, Senior Vice President NMLS ID # Matthew J. Hickey, Vice President NMLS ID # Ryan Bancsy, Loan Officer NMLS ID # *Consumers may ook up information about our enders, using the NMLS ID # s, by visiting

2 TYPE OF ACCOUNT REQUESTED HOME EQUITY LOAN APPLICATION Check one to indicate the type of account you are requesting. Note: Married appicants may appy for separate accounts. Joint Account Individua Account - Reying on my income and assets and as we as income or assets of another. TERMS REQUESTED Amount No. of Months COLLATERAL PROPERTY Interest Rate Payment Type of Loan % Fixed Rate Purpose Individua Account - Reying soey on my income and assets. ARM (type): PLEASE TYPE OR PRINT Other: / Month Home Improvement Pay Debt: Other: Home Equity Line of Credit Address Year Buit Date Purchased Present Vaue Baance Owing Tite in Name(s) of: Address of Tite Hoder Name and Address of Insurance Carrier Mortgage Hoder Name Address Phone No. Acct. No. INDIVIDUAL APPLICANT INFORMATION Name Birthdate Socia Security No. Address (Street, City, State, Zip) County Driver s License No. Home Phone Business Phone No. of Dependents Ages of Dependents Empoyer/Sef Empoyed Position Years Empoyed Empoyer's Address Wages, Saary, Commissions How Often Paid Gross /month Net /month Previous Empoyer Position Years Empoyed Previous Empoyer's Address Name and Address of Appicant's Nearest Reative Reationship Aimony, chid support, or separate maintenance income need not be reveaed if you do not wish to have it considered. Aimony, chid support, separate maintenance received pursuant to: Court Order Written Agreement Other Income: Source Marita Status Married Separated Unmarried (incudes singe, divorced and widowed) Ora Understanding. Amount/Month JOINT APPLICANT OR OTHER PARTY INFORMATION Provide the information in this section for a joint appicant, another party that wi use or contribute assets or income toward repayment on the account, or for your spouse if you ive in, or the coatera property is ocated in, AZ, CA, ID, LA, NM, NV, TX, WA or WI. Name Birthdate Socia Security No. Address (Street, City, State, Zip) County Driver s License No. Home Phone Business Phone No. of Dependents Ages of Dependents Empoyer/Sef Empoyed Position Years Empoyed Empoyer's Address Wages, Saary, Commissions How Often Paid Gross /month Net /month Previous Empoyer Position Years Empoyed Previous Empoyer's Address Name and Address of Joint Appicant's or Other Party's Nearest Reative Reationship Aimony, chid support, or separate maintenance income need not be reveaed if you do not wish to have it considered. Aimony, chid support, separate maintenance received pursuant to: Court Order Written Agreement Ora Understanding. Other Income: Source Amount/Month Marita Status Married Separated Unmarried (incudes singe, divorced and widowed) GENERAL INFORMATION If you or a joint appicant or other party answers "yes" to any of the foowing questions, pease expain in the space provided. Are you a guarantor or co-maker of any eases, contracts or debts? Appicant: Yes No Joint Appicant/Other Party: Yes No Are there any suits or judgments pending against you? Appicant: Yes No Joint Appicant/Other Party: Yes No (Incude amount) Have you been decared bankrupt in the ast 10 years? Appicant: Yes No Joint Appicant/Other Party: Yes No.. PREVIOUS CREDIT REFERENCES Describe any previous debt obigations. Pease mark Appicant-reated information with an "A". 1. Date Paid 2. Date Paid NOT FOR FNMA/FHLMC/FHA/VA USE. Bankers Systems, Inc., St. Coud, MN Form HE-APP 2/18/2000 (page 1 of 2) -C486 (0006).01 VMP MORTGAGE FORMS - (800)

3 ASSET AND DEBT INFORMATION If "Joint Appicant or Other Party Information" section was competed above, this section shoud be competed giving information about both the Appicant and the Joint Appicant or Other Party. Attach additiona sheets if necessary. ASSETS DESCRIPTION OF CURRENT ASSETS NAME(S) OF OWNER(S) SUBJECT TO DEBT: YES/NO VALUE Checking Accounts (Institution, Acct. No.) Savings Accounts (Institution, Acct. No.) Automobies (Make, Mode, Year) Marketabe Securities (Issuer, Type, No. of Shares) Life Insurance Cash Vaue (Issuer) Other Rea Estate (Location, when acquired) Other Assets (Describe) Tota Assets 0 OUTSTANDING DEBTS (Incude a charge accounts, instament contracts, credit cards, rents, mortgages and other obigations.) ACCOUNT NAMES IN WHICH THE ORIGINAL PRESENT CREDITOR NUMBER ACCOUNT IS CARRIED AMOUNT BALANCE Auto Loans MONTHLY PAYMENTS Credit or Charge Cards Landord or Mortgage Hoder on other Rea Estate Other TOTAL DEBTS NOTICE - APPRAISAL COPY: We may order an appraisa to determine the property s vaue and charge you for this appraisa. We wi prompty give you a copy of any appraisa, even if your oan does not cose. You can pay for an additiona appraisa for your own use at your own cost. NOTICE - APPRAISAL - JOINT CREDIT: COPY: You have the right to a copy of the appraisa report used in connection with your appication for credit. If you wish a copy, pease write to us at the maiing address we have provided. We must hear from you no ater than 90 days after we notify you about the We a ction intend taken to appy on your for credit joint appication credit. (Initias) or you withdraw your appication. In your etter, give us the foowing information: Loan or appication num ber (if known), date of appication, name(s) of oan appicant(s), property address, and current maiing address. I certify that everything I have stated in this appication and on any attachments is correct. You may keep this appication whether or not it is approved. By signing beow, I authorize you to check my credit and empoyment history, to have a consumer credit report prepared on me for the purpose of evauating this appication for credit, and to answer questions others may ask you about my credit record with you. I understand that I must update this credit information at your request and if my financia condition changes. I acknowedge receipt of the Home Equity Brochure and the ender's Home Equity discosure statement on today's date. Appicant Date Joint-Appicant Date CREDITOR USE ONLY This appication was taken by: face-to-face interview mai teephone. Date Appication Received: Received By: Amount Requested Date Appication Competed: Approved By: Amount Approved / Rescindabe? RESPA Appicabe? Funding Date: Initia Advance Yes No Yes No IMPORTANT APPLICANT INFORMATION: Federa aw requires financia institutions to obtain sufficient information to verify your identity. You may be asked Bankers Systems, Inc., St. Coud, MN Form HE-APP 2/18/2000 severa questions and to provide one or more forms of identification to fufi this requirement. In some instances we may use outside sources to confirm the -C486 ( ).0 1 information. The information you provide is protected by our privacy poicy and federa aw. (page 2 of 2)

4 REQUEST FOR INFORMATION FOR GOVERNMENT MONITORING PURPOSES FIRST BANK OF MANHATTAN 230 STATE STREET MANHATTAN, IL Date of Credit Appication Date: LENDER NAME AND ADDRESS BORROWER NAME AND ADDRESS Dear Appicant(s): The foowing information is requested by the federa government for certain types of oans reated to a dweing in order to monitor the ender's compiance with equa credit opportunity, fair housing, and home mortgage discosure aws. You are not required to furnish this information, but are encouraged to do so. You may seect one or more designations for "Race." The aw provides that a ender may not discriminate on the basis of this information, or on whether you choose to furnish it. However, if you choose not to furnish the information and you have made this appication in person, under federa reguations the ender is required to note ethnicity, race, and sex on the basis of visua observation or surname. If you do not wish to furnish the information, pease check beow. APPLICANT: CO-APPLICANT: I do not wish to furnish this information I do not wish to furnish this information Ethnicity: Ethnicity: Hispanic or Latino Not Hispanic or Latino Hispanic or Latino Not Hispanic or Latino Race: Race: American Indian or Aaska Native Asian Back or African American Native Hawaiian or Other Pacific Isander White American Indian or Aaska Native Asian Back or African American Native Hawaiian or Other Pacific Isander White Sex: Sex: Femae Mae Femae Mae Pease return this form to the ender at the address isted above , 2003 Bankers Systems, Inc., St. Coud, MN Form MONITOR C 8/22/2003 (page 1 of 1)

5 BORROWER S CERTIFICATION AND AUTHORIZATION The Undersigned certify the foowing: CERTIFICATION 1. I/We have appied for a mortgage oan from FIRST BANK OF MANHATTAN. In appying for the oan, I/We competed a oan appication containing various information on the purpose of the oan, the amount and source of the down payment, empoyment and income information, and the assets and iabiities. I/We certify that a of the information is true and compete. I/We made no misrepresentations in the oan appication or other documents, nor did I/We omit any pertinent information. 2. I/We understand and agree that FIRST BANK OF MANHATTAN reserves the right to change the mortgage oan review process to a fu documentation program. This may incude verifying the information provided on the appication with the empoyer and/or the financia institution. 3. I/We fuy understand that it is a Federa crime punishabe by fine or imprisonment, or both, to knowingy make any fase statements when appying for this mortgage, as appicabe under the provisions of Tite 18, United States Code, Section To Whom It May Concern: AUTHORIZATION TO RELEASE INFORMATION 1. I/We have appied for a mortgage oan from FIRST BANK OF MANHATTAN. As part of the appication process, FIRST BANK OF MANHATTAN may se my mortgage, any and a information contained in my/our oan appication and in other documents required in connection with the oan, either before the oan is cosed or as part of its quaity contro program. 2. I/We authorize you to provide to FIRST BANK OF MANHATTAN and to any investor to whom FIRST BANK OF MANHATTAN may se my/our mortgage, any and a information and documentation that they request. Such information incudes, but is not imited to, empoyment history and income; bank, money market and simiar account baances; credit history; and copies of income tax returns. 3. FIRST BANK OF MANHATTAN or any investor that purchases the mortgage may address this authorization to any party named in the oan appication. 4. A copy of this authorization may be accepted as an origina. Borrower Signature SSN: Date: Borrower Signature SSN: Date:

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7 APPRAISAL WAIVER OF THREE-BUSINESS DAY DELIVERY REQUIREMENT Appicant: Property Address: By signing beow, I waive my right to receive a copy of the appraisa report or other written evauation for the above referenced property three (3) business days prior to the cosing of the oan. This waiver does not affect my right to receive a copy of the appraisa report under the Equa Credit Opportunity Act or other aw. Borrower Date Co-Borrower Date

8 Property Description Form Borrower: Address: Subdivision: Design (Stye): Ranch 2 Story Spit Leve Other Year Buit: Tota Number of Rooms: # of Car Garage: Attached: Yes No Bedrooms: Outbuidings: Yes No (i.e. Sheds, Poe buidings, etc.) Baths: # of Outbuidings: Gross Living Area: Lot Size: Finished Basement: Recent Upgrades/Repairs: X Borrower X Co-Borrower

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