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V.  MONTHLY INCOME AND COMBINED HOUSING EXPENSE INFORMATION
Gross Monthly Income Borrower Co-Borrower Total Combined  Monthly Housing Expense Present Proposed
Base Empl. Income* $ $ $ Rent $ $
Overtime $ $ $ First Mortgage (P&I) $ $
Bonuses $ $ $ Other Financing (P&I) $ $
Commissions $ $ $ Hazard Insurance $ $
Dividends/Interest $ $ $ Real Estate Taxes $ $
Net Rental Income $ $ $ Mortgage Insurance $ $
Other (see Þ  below) $ $ $ Homeowner Assn. Dues $ $
$ $ $ Other: $ $
Total $ $ $ Total $ $

*Self Employed Borrower(s) may be required to provide  additional documentation such as tax returns and financial statements.
Describe Other Income Notice: Alimony, child support, or separate maintenance income need not be revealed if the Borrower(B) or  Co- Borrower(C) does not choose to have it considered for repaying this  loan.

B/C . Monthly Amount
. . $
. . $
VI.  ASSETS AND LIABILITIES
This statement and any applicable  supporting schedules may be completed jointly by both married and  unmarried Co- borrowers if their assets and liabilities are  sufficiently joined so that the statement can be meaningfully and  fairly presented on a combined basis; otherwise separate Statements  and Schedules are required. If the Co- Borrower section was  completed about a spouse, this Statement and supporting schedules  must be completed about that spouse also.
 
  Completed   Jointly Not Jointly
 
ASSETS Cash or Market
Value 		Liabilites and Pledged Assets. List the creditor's name, address and account number for all  outstanding debts, including automobile loans, revolving charge  accounts, real estate loans, alimony, child support, stock pledges,  etc. Use continuation sheet, if necessary. Indicate by (*) those  liabilities which will be satisfied upon sale of real estate owned  or upon refinancing of the subject property.
 
Cash deposit toward purchase held by: $ LIABILITES Monthly Pmt. &
Mos. Left to Pay 		Unpaid
Balance
 
List checking and savings  accounts below    
Name & Address of Bank, S&L,  or Credit Union
  		Name & Address of Company
  		$ Pat/Mos.
:  		$
-
Acct. no. $ Acct. no.  
Name & Address of Bank, S&L,  or Credit Union
:  		Name & Address of Company
  		$ Payt./Mos.
:  		$
-
Acct. no. $ Acct. no.  
Name & Address of Bank, S&L,  or Credit Union
  		Name & Address of Company
  		$ Payt./Mos.
  		$
 
Acct. no. $ Acct. no.  
Name & Address of Bank, S&L,  or Credit Union
  		Name & Address of Company
  		$ Payt./Mos.
  		$
-
Acct. no. $ Acct. no.  
Stocks & Bonds(Company name/  number & description)
 $
  		Name & Address of  Company
  		$ Payt./Mos.
  		$
 
Acct. no. $ Acct. no.  
Life insurance net cash value
  		. Name & Address of Company
  		$ Payt./Mos.
  		$
-
Face amount $ $ Acct. no.  
Subtotal Liquid Assets $ Name & Address of  Company $ Payt./Mos. $
Real Estate owned enter market value from  schedule or real estate owned, (page 3.)
 $ Acct. no.  
Vested interest in retirement  fund $ Name & Address of  Company $ Payt./Mos. $
Net worth of business(es) owned (attach  financial statement) $ Acct. no.  
Automobiles owned (make and year) $ Alimony/Child  Support/Separate Maintenance Payments $ .
Other Assets  (itemize)
$
 Job Related Expense  (child care, union dues, etc. )
 $ .
Total Monthly Payments $ .
Total Assets a. $ Net Worth (a-b) $ Total Liabilities b. $