BANK OF LOUISIANA101 SOUTH THIRD STREET

LOUISIANA, MO 63353(5731754-5517

Thank you for considering Bank of Louisiana for your mortgage needs. We are looking forward to the opportunityto serve you. Listed below is a simple checklist to aid you in gathering information necessary for us to processyour mortgage loan request. By providing the requested information, you will allow us to expedite the loanprocess and provide you with a decision in a minimal amount of time. Please do not hesitate to give us a call withany questions at (573) 754-5517 .

THE APPLICATIONPlease complete the application in its entirety, providing name(s), addresses, account numbers, and balances (ifapplicable), employers (2 years minimum), assets (checking, savings, etc.) and liabilities (loans).

FINANCIAL STATEMENTS. Two years personal income tax return (complete 1040) along with W-2's. YTD pay stubs covering the past 30 days. 3 Months of Bank Statements for all accounts

lf you are self-employed:. Three years company complete tax returns. YTD Financial Statement for the Company (most recent quarter). P&LBalanceSheet

. Sales contract with original signatures of buyer and seller

. Real estate company, agent's name, address, and phone numbers

. Estimate of annual taxes 3!g homeowner's insurance

. Copy of cancelled check for earnest moneyREFINANCE

. Current homeowners insurance policy ytilh yearly premium amount

. Copy of existing title insurance policy (if available)

. Survey (if available)

. Assessed value of home and/or copy of paid real estate tax receipt for the most recent tax year

. lvlortgage statementCONSTRUCTION LOANS

. copy of legal description or copy of recorded Warranty Deed

. Set of plans/blueprints

. Cost Breakdown

. Contract with builder

Please contact one of our mortgage lenders and they will be happy to set up an appointment with you to discussyour applicatjon. You will need to bring the completed application and supporting documentation along with acheck in the amount of $23.00 payable to Bank of Louisiana. This fee will go toward the cost of the mortgagecredit report.

ln accordance with the provisions of the Secure and Fair Enforcement for Mortgage Licensing Act of 2008 (SAFEAct) and Subpart I of Federal Reserve Board Regulation H adopted thereunder, Bank of Louisiana is a registeredl\ilortgage Loan Originating (NilLO) financial institution. All loan officers who are authorized to originate mortgageloans are also registered. To find out more information about what this registration means and to inquire as to ourfinancial institution information and information about our mortgage loan originators, please visithttp://www.nmlsconsumeraccess.orq/. The bank's information will be available for viewing after July 29, 201 '1.

THE FINANCING OF YOUR HOME IS A MAJOR STEP IN HOME OWNERSHIP AND WE WILL MAKE EVERYEFFORT TO HANDLE YOUR REQUEST IN AN EFFICIENT AND PROFESSIONAL MANNER.

ADOITIONAL INFORMATIONPURCHASES

BANI(OF

TOUISIAT{AIOI SOUTH THIRD ST, LOUISIANA, MISSOURI63353

AUTHORIZATION TO RELEASE INFORMATION

TO WHOM IT MAY CONCERN:

I/We have applied for a mortgage loan from Bank of Louisiana. As part of the applicationprocess, Bank of Louisiana may verify information contained in my/our loan application and inother documents required in connection with the loan, either before the loan is closed or as part

of its quality control program.

I/We authorize you to provide Bank of Louisiana, and to any investor to whom Bank ofLouisiana may sell my mortgage, and any and all information and documentation that theyrequest. Such information includes, but is not limited to, employment history and income; bankmoney market, and similar account balances, credit history; and copies of income tax returns.

Bank of Louisiana or any investor that purchases the mortgage may address this authorizationtoany party named in the loan application.

A copy of this authorization may be accepted as an original.

Your prompt reply to Bank of Louisiana or the investor that purchased the mortgage is

appreciated.

Date Date

Borrower's Signature Borrower's Signature

Date of Birth Date of Birth

Social Security # Social Security #

RIGHT TO RECEIVE A COPY OF APPRAISAL REPORT

FROM:BANK OF LOUISIANA1O1 South Third StreetLouisiana, MO 63353

TO:BORROWER

Loan Number:Notice Date:Property Address:

Right to Receive CopyWe may order an appraisal to determine the property's value and charge you for this appraisal. We

will promptly give you a copy of any appraisal, even if your loan does not close.You can pay for an additional appraisal for your own use at your own cost.

Acknowledgment

By signing below, you acknowledge you have received this Disclosure.

Date

%S" 1

RIGHT TO RECEIVE A COPY OF APPRAISAL REPORT

FROM:BANK OF LOUISIANA101 South Third StreetLouisiana, MO 63353

TO:CO-BORROWER

Loan Number:Notice Date:Property Address:

Right to Receive CopyWe may order an appraisal to determine the property's value and charge you for this appraisal. Wewill promptly give you a copy of any appraisal, even if your loan does not close.You can pay for an additional appraisal for your own use at your own cost.

Acknowledgment

By signing below, you acknowledge you have received this Disclosure.

Date

PrS" 1

FEDERAL CREDIT APPLICATION INSURANCE DISCLOSURE

I have applied for an extension of credit with you. You are soliciting, offering, or selling me an

insurance product or annuity in connection with this extension of credit. FEDERAL LAW PROHIBITSYOU FROM CONDITIONING THE EXTENSION OF CREDIT ON EITHER:

1 . My purchase of an insurance product or annuity from you or from any of your affiliates; or2. My agreement not to obtain, or a prohibition on me from obtaining, an insurance product orannuity from an unaffiliated entity.

By signing, I acknowledge that I have received a copy of this form on today's date or within three (3)

days if I have applied by telephone. Unless this disclosure is provided electronically or I have applied forcredit by mail, I also acknowledge that you have provided this disclosure to me orally.

BORROWER:

Date

For Telephone Applications Only:

As an authorized representative of Lender, I confirm that I have made the above Credit Applicationlnsurance Disclosures orally to the Applicant(s) and that the receipt of the oral disclosures wereacknowledged orally by the Applicant(s). I also confirm that I have mailed to the Applicant(s) the aboveCredit Application lnsurance Disclosures within three (3) days beginning the first business day after theapplication is taken, excluding Sunday and federal public holidays.

Authorized Representative (Date)

lnitials _Page 1

SERVICING DISCLOSURE STATEMENT

LENDERBANK OF LOUISIANA1O1 South Third StreetLouisiana, MO 63353

BORROWER

Date

Loan Number

Property Address

NOTICE TO FIRST LIEN MORTGAGE LOAN APPLICANTS: THE RIGHT TO COLLECT YOUR MORTGAGE LOAN PAYMENTS MAY BE TRANSFERRED.

You are applying for a mortgage loan covered by the Real Estate Settlement Procedures Act (RESPA) (12 U.S.C. 2601 et seq.). RESPA gives you certain rights under Fed

any, as well as sending any monthly or annual statements, tracking account balances, and handling other aspects of your loan. You will be given advance notice be

occurs.

Servicing Transf er lnf ormation

We may assign, sell, or transfer the servicing of your loan while the loan is outstanding.

Page 1Wolters Kluwer Financial Services @'l 996, 20'16 Bankers Systemsrslnitials

REGULATION B. NOTICE OF INTENT TO APPLY FOR JOINT CREDIT

APPLICANTS:

LENDER:BANK OF LOUISIANA101 South Third StreetLouisiana, MO 63353

NOTICE. We intend to apply for joint credit.

ACKNOWLEDGMENT. By signing below, we acknowledge the intention to apply for joint credit on

Date

Date

lnitials _Page 1

as applicable. Co-Borrower information must also be provided (and the appropriate bmhecked) when L-l the income or assets of a person other than the Borrower

(including the Borrower's spouse) will be us6d as a basis for loan qualiflcatjon or E ,n" ,n"or" or assets of the Borrow€r's spouse or other person who has

This application is designed to be completed by the applicant(s) with the Lender's assistance

community property rights pursuant to state law will not be used as a basis for loan qualification, but his or her liabilities must be considered because the spouse or

other person has community property rights pursuant to applicable law and Borrowcr rcsidcs in a community propcrty statc, the security propcrty is located in a

community property state, or the Borrower is relying on other property locatod in a community property state as a basis for repayment of the loan.

lf this is an application forjoint credit. Borrower and Co-Eorrower each agree that we intend to apply forjoint credit (sign below)l

MortgageApplied for

Amount Existing Liens Purpose of Refinance

Total (a + b)

Describelmprovements L-l made LJ to be made

Esbte will be held in:

E ree s,moteI---.l Leasehoid t.m*tJ expr.ailm dale)

Dependents (nor listed by Borowed

Own L-l Rent _ No. Yrs

Lender Case Number

No. of units

Year Built

Secondary

Yrs. on thisjob

Yrs. emoloved in this lineof wbrldprofession

Datcs (from - to)

Monthly lncome

Amount

$

AmortizationType:

Fixed Rate

GP[iI

Subject Property Address (street, city, state & zlP)

Legal Description of Sub.ject Property (attach description if necessary)

Purpose of Loan

Complete this line if consfuuction or construction-permanent loanYear Lot I ongrnal CosrAcquired

trtv wrll bePr'imary

Amount Existing Liens (a) Prcscnt Valuc of Lot (b) Cost of lmprovcmcnts

loan.YearAcquired

this line if this is aOriginal Cost

Title will be held in what Name(s)

Source of Down Payment, Settlement Charges, and/or Subordinate Financing (explain)

Borrowefs Name (include Jr, or Sr. if applicable)

Social Secur (y Number

Co.Sorrower s Name (include Jr. or Sr. if applicable)

No. Yrs Present Address (srEr, ciry srate, ZIP)

Mailing Address, if different from Present Addross

Former Address (stret. city, state. ZIP)

Schd

Mailing Address, if different from Present Address

address for less than two

Present Address (rteer. crty. state. zlP)

Former Address (srer, c[y, stare, zlP) L_l O*n

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Name & Address of Employer Selr Employed

Name & Addrcss of Employor I serrr-pr"yo

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vMP2rN (0907).O1Page I of 4

Purchase l-l Con\truc(ron L-l other (explarn)

Manner in which Title will be held

Home Phono (incl. area code)Home Phone (incl, area code)

Name & Address of Employer L_l s.rr e.proyeoYrs. on thisjob

Namc & Addrcss of Employcr I Sotr f-proy.a

Address of Employer [__l sar r.6paSdr Empbyd

-

No. Yrs. No. Yrs.

Gross Mohftly lffiome

Base Empl. lncome*

Commissions

Dividends/lnterest

Net Rental lncome

(hlo.e cmpleting,see the nori.e n "describeorher incom.. ' bclow)

Total

or Co.Botrows, (C) do6s not choose to havo n cohsidorod for r€paying lhis loan. Monthly Amount

the Co.Eoir;wer section was completed about a non.apilicaht spouse oi other persoh, this Statement and suppofrno schpdules must be comoleted about that soouseoI other person also ao.o,"r"o F ,o,nuu E Not lorntlv

Assts. List tk crdrtor's narc, address, ad accNnt numbr ld all outstanding debts,

ASSETS

This Statement and any applicable supporting schedules may be completed Jorntly by both maried and unmarried Co-Borrowers if their assets and liabilities are

sufficimtly joined so th;t thi Stute*en't ."n b'e meaningFully ind fairly ircscnt6O ori a iombrncd basis; otheMisc,. separate Statcments and Schcdulcs are required. lf

Cash deposit toward purchase held byl

Name and address of Bank, 5&1, or Credit union

Name and address of Bank, S&1. or Credit Union

Name and address of 8ank, S&1, or Credit union

Name and address ol Bank, S&1, or Credit Union

Stocks & Bonds (Company name/number& description)

Life insurance net cash value

Subtotal Liquid Assets

Real estate owned (enter market valueFrom schedule of real estate owned)

Vested interest in retirement fund

Net worth of business(es) owned(attach flnancial statement)

owned (make and year)

Other Assets (itemize)

Total Assets a.

ircluding autmdile bons. rwfring charge.ccents, teal esbte bans, alimny, child $ppo(, stock pldges, etc.Us cmtinuarion !het, i, re€ssary. lndicate by (') tho$ liabilities, which dll be stisfid upn sle of real estate

Unpaid Balance

Uniform Resrdential toan Applica!onFannre Mae/Freddre Mac

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' Sd Employd Borower(s) my bo r6quir6d to p.ovide additional documentatid such as lax roturns and timncial statoments.

D6scrib€ Othor lncome Notic€: Alimony, child suppod, or sep.rat6 maintenarce income noed noi & reveaH if the Borrow€r (B)

Name and address of Company

Name and address of Company

Name and address of Company

Name and address of Company

Name and address of Company

Name and address of Company

Name and address of Company

Fannie Mae Form l@3 7/05 (Rev. &Og)Frddie Mac Form 65 7/O5 (Rev. 5/os)

vMP2l N (0907).01Page 2 of 4

Prope(y Address (enter S if sold, PS rf pendrng saleor R f rental berng held for .ncome)

Gross Mongage Net

Alternate Namc Crcditor Name Account NumberList any additional names under which credit has previously been received and indicate appropriate creditor naru(s) and account number(s):

lf you answer "Yes" to any questions a through i, pleaseuse continuataon shet for explanauon.

a. Are there any outstandingjudgments against you?

b. Have you been declared bankrupt within the past 7 years?

c. Have you had property foreclosed upon or given title or deed inlieu thereof in the last 7 years?

d. Are you a party to a lawsuit?

Race:

EE nEEEEEEE

Have you directly or indirectly been obligated on any loan which resulted in foreclosure,transfer of title in lieu of foreclosure, orjudgment? (This would include such loans as homemortgage loans, SBA loans, home improvement loans. educational loans, manufactured(mobile) home loans, any mortgage, financial obligation, bond, or loan guarantee, lf "Yes,"proude detarls, rncludin-g date; iame, and addiass of Lender,

---FHAoivAiaiinumuer,ltiny,'anorcasonsfortheaction.) LJ L_]lE E

l. Other Credits {explain)

f. Are you presently delinquent or in default on any Federal debt orany other loan, moftgage, financial obligation, bond, or loanguarantee? lf 'Yes." give details as described in the precedingquestion.

g, Are you obligated to pay alimony, child support, or scparatemaintenance?

h. ls any part of the down payment borrowed?

i1':I::-"-:::T:f ::-' j"ld-"-'-':1"r-3-1"-'-"-?-j. Are you a U.S. citizen?

k. Are you a permanent resident alien?

l. Do you intend to occupy the property as your primaryresidence? lf "Yes,' complete question m below.

m. Have you had an owncrship interest in a propeny in thc lastthree vears?(1) What type of propeily did you own -. principal residence

(PR), second home (SH), or rnvestment propedy (lP)?(2) How d,d you hold title to the home - ' solely by yourself {S),

EE EEEN

p. Cash from/to Borrower wiih your spouse (sP), orjointly with a'nother person

Borrower's Signature

x

BORROWER

Race

m, Loan amount(exclude PMl, MlP, Funding Fee financed)

Gher Pacifrc lslander

Sex;

Nabve Hawaian orOther Pacinc lslander

T]E

oThis information was provided E ln a fac+to-face interview E Ay tnu applicant and submitted by fax or mail

and submitted via e-mail or the lnternet

57 3-1 54-5511

SOUTH THIRD STREEI

Un'form Resrdental Loan Apd'6tonFcnn,e Mae/FreJJ,e MdL

Wolters Kluwer fnrancial Services

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ach of Se undersignd .+resrs to Lddd .nd to tdtr's.ctusl or Ftentad sgents, br*ss, p.@essors. attdneys, rnsrers, sflicds, successds.nd assl$s ahd .gres and

a facamab of my signalure, shall be as effective, enforceable and valid as if a paper version of this application were delivered conhining my oiginal written signature.

slate law for se pa^acular lype of loan apiled ror.)

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FannE Mae Form l@3 7/O5 (Rev. &Og)Frddie Mac Fsm 65 7/O5 (Rd. flOg)

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llse this continuetron sheet rfyou nccd more spacc tocomplete the Resrdental LoanApplrcatron. Mark B forBdrrower or C for Co-Borrower.

Agency Case Number:

Lender Case Number

l/We fully understand that t is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements concerning any of the above factsas applicable under the provisions of Title 18, L,nited States Code, Section 1OO1, et seq.

Borrower's Signaturo:

x

Unirorm Residential Loan ApplicationFannie Mae/Freddre MacVMP CiWolters Kluwe, Fnrancial Seruices

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lnitials

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Fannje lvlae Form 1m3 7/05 (Rev. 6/09)Frddie Ma. Fo,m 5s 7/o5 (Rev. 6/09)

vMP2lN (0907).O1Page I ol 1

ro,. 45O6-T(Rev. August 2O14)

Depanment of the TreasuryRevenue

Request for Transcript of Tax Return) Request may be rejected if the form is incomplete or illegible.

) For more information about Form 4506-T, visitwww.irs.gov/form45o6t.OMB No. 1545-1472

Tip. Use Form 4506-T to order a transcript or other return information free of charge. See the product list below. You can quickly requesttranscriptsby usingour automatedself-help servicetools. Pleasevisit usat lRS.gov andclick on "Get Transcript of Your Records" under"Tools" or call 1 -800-908-9946. lf you need a copy of your return, useForm 45O6, Request for Copy of Tax Return. There is a fee to get a

copy of your return.return, enter irst on tax return,

individual taxpayer number, oremployer identification number (see instructions)

2a lf aJoint return, enter spouse's name shown on tax return, Second social security number or individualtaxpayer identification number if joint tax return

3 Current name, address (including apt., room, or suite no.), city, state, and ZIP code (see instructions)

4 Previous address shown on the last return filed if different from line 3 (see instructions)

5 lf the transcript or tax information as to be mailed to a third party (such as a mortgage company), enter the third party's name, address,and telephone number.

.nter the tax y one tax

a ReturnTranscript,whichincludesmostofthelineitemsofataxreturnasfiledwiththelRS.Ataxreturntranscriptdoesnotreflectchanges made to the account after the return is processed. Transcripts are only available for the following returns: Form 1 040 series,Form 1065, Form 1120, Form 1120A, Form 1120H, Form 1120L, and Form 1120S. Return transcripts are availablefor the current _yearandreturnsprocessedduringtheprior3processingyears.MostrequestswillbeprocessedwithinlObusinessdays_ f_l

b Account Transcript, which contains information on the financial status of the account, such as payments made on the account,penalty assessments, and ad.lustments made by you or the IRS after the return was filed. Return information is limited to items such aspenalty assessments, and adjustments made by you or the lR5 after the return was f iled. Return information is limited to items such astax liability and estimated tax payments. Accounttranscripts are available for most returns. Most requests will be processed within 10 rbusinessituv Ibusiness days

c Record of Account, which provides the most detailed information as it is a combination of the Return Transcript and the AccountTranscript. Available for current year and 3 prior tax years. Most requests will be processed within '10 business aays- l-.l

7 Verification of Nonfiling, which is proof from the IRS that you did not file a return for the year. Current year requests are only available

after June 1 5th. There are no availability restrictions on prior year requests. Most requests will be processed within 1O business Oays. l--l8 Form W-2, Form 1099 series, Form 1O98 series, or Form 5498 series transcript. The IRS can provide a transcript that includes

data from these information returns. State or local information is not included with the Form W-2 information. The IRS may be ableto provide this transcript information for up to 10 years. lnformation for the current year is generally not available until the yearafter it is filed with the lRS. For example, W-2 information for 2011, filed in 2012, will likely not be available from the IRS until2013. lf you need W-2 information for retirement purposes, you should contact the Social Security Administration a!_1.8oo.772-1213.MostrequeStswillbeprocessedwithin10businessdaysll

Caution. lf you need a copy of Form W-2 or Form 1O99, you should first contact the payer. To get a copy of the Form W-2 or Form1099 filed with your return, you must use Form 4506 and request a copy of your return, which includes all attachments.9 Year or period requested. Enter the ending date of the year or period, using the mm/dd/yyyy format. lf you are requestrng more than four

years or periods, you must attach another Form 4506-T. For requests relating to quarterly tax returns, such as Form 941, you mustenter each quarter or tax period separately.

Signature (see instructions)

Caution. Do not sign this form unless all applicable lines have been completed.Signatureoftaxpayer(s).ldeclarethatlameitherthetaxpayerwhosenameisshownonlinela or2a,or apersonauthorizedtoobtainthetai information reQuested. lf the request applies to a ioihtleturn, at least one spouse must siqn. lf siqned by a corporate officer, partner,quardian, tax matters partner, executor, receiver, admifristrator, trustee, or partv cither than the t-axoaver; I certifv that'l have the autrioritv to6xecute Form 4506-T'on behalf of the taxpayer.Note. For transcripts beiig s6nt to a third party,'tllis form mdst be received within 1ZOdays of the signature date.

;'# I

Caution: lf the taxtranscriptis beinq mailed toa third partv. ensure thatvou have filled in lines6 throuqh 9 before sioninq. Siqnand date theform once vou have filled in theselines. Completinq thes-e steps helps [o protect vour Drivacv. Oncelhe IRS disclo-ses-vour-tax transcriDt tothe third pa'r.ty llsted on line 5, the IRS has no contr6l over whdt the ihird party doeis with the information. lf you would like to limit the th'irdparty's authoiity to disclose your transcript information, you can specify dhis fimitation in your written agreefrrent with the third party.

Phone number of taxpaver online 1a or 2a

Title (if line 'la above is a corporation, partnership, estate. or trust)

Wolters Kluwer financial Seruices

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Cat. No. 37667NFor Privacy Act and Paperwork Reduction Act Notice, see page 2. Form 4506-T (Rev. 8-2014)VMP9045T (1410).00

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Form a506-f (Rev. 8-2014)

Section referen€es are to the lntemal RevenueCode unless otherwse noted.

Future DevelopmentsFor the latest information about Fom 4506-T andits instructions, oo towwwrrs oov/form4506l. lnromation aboutdny recent-developments dffectrng Torm 4506-T(srch as leqrslatron endcted after we released rl)will be posted on that page.

General lnstructionsCaution. Do not sron this form unless allapplicable hnes have been completed.Purpose of torm. Use Iorm 4506-l to,equesrtax return rnformat'on. You can also delignate{on line 5) a third pany to ecervF rhe information.Taxpayers using a tax year beginning in one(alendar year and endrng rn the tollowrng year(fiscal tax year) must f le Fom 4506 T to request

Note. lf you are unsure of which type ofvanscript you need, reqlest the Record ofAccount, as it provides the most detailed

Tip. Us€ Form 4506, Request ror Copy of TaxRetu.n, to requesl copies of tax returns.

Automated transcript request. You canquickly rcquest ranscripts by using ourautomated self'help seruice tools. Please visit usat lRs.gov and click on Get Transcript of YourTax Records under 'Tools or call'r -800,908-9946.

Where to file. Mail or fax Form 4506-T to theaddress bebw ror the state you lived in, or thestate your business was in, when ihat return wasfiled. The.e are two address cha(s: one forindividual vanscipts (Form 1040 series and FormW'2) and one for all o$er transcripts.

lf you are requestinq more than one transcriptor other product and the chart below shows twodifferent addresses, send your request to theaddress based on the address of your most

Chart for individual transcripts(Form 1O40 series and Form W-2and Form 1099)lf vou filed an Mail or fax to:individual returnand lived in:Alabama, Kentucky,

Mississrppi,fennessee, Texas, aforeign country, AmericanSamoa, Puerto Rico,Guam, theCommonwealth of theNonhern Mariana lslands.the u.s. virgin lslands, orA.P.O. or F.P.O.

Chart for all otherlf you lived in oryour.business

Parinerships. Generally, Form 4506-T can besigned by any person who was a member of theparLnership durinq any part of the tax peiod.equested on line 9.

All others. See section 6103(e) if thetaxpayer has died, is insolvent, is a dissolvedcorporation, ol a trus(ee. guardlan, executor.recever, or administrator is acting for the

Documentation. For entities other thanindividuals, you m'rst attach the authorizationdocument. For example, this could be the letterfrom the principal offlcer authorizang anemployee of the co.poration or the letterstestamentary authorizinq an individual to act for

Signature by a representative. Arepresentative can sign Form 4506-T ror ataxpayer only if the taxpayer has specificallydelegated this authority to the representative onForm 2848, line 5. The representative mustattach Form 2848 showing the delegation toForm a506-T.

transcriptsMail or fax to:

California, Colorado,Florida, Hawaii, ldaho,lowa, Kansas, Louisiana,Minnesota, Mississippi,

Dakota, Oklahoma,Oreqon, South Dakota,

Washrngton, Wyoming,a foreign country, orA.P.O. or F.P.O. address

lnternal Revenue ServiceRAIVS TeamP O. Box 9941MailStop 6734Ogden, UT 84409

4o1.620.6922

Wvnmrn.

Line 1b. Enter your employer identificationnumber (ElN) ir your request relates to a businessreturn, OtheMise, enter the first soclal securitynumber (SSN) or your individual taxpayeridentification number (lTlN) shown on the return.For example, il you are requesting Fom 1040 thatncludes Schedute C (Form 1040). enter your SSN.

Line 3. Enter your cunent address. lf you use aP.O. box. include it on this line.

Line 4. Enter the add.ess shown on the lastreturn filed ar different r.om the address entered

Note. lf the address on lines 3 and 4 aredifferent and you have not changed your addresswith rhe lRS, file Form 8822, Change of Acdress.For a business address. file Form 8822-8, Changeof Address or Responsible Party - Business.

Line 6. Enter only one tax folm number per

Signature and date. Form 4506-T must besigned and dated by the taxpayer lasted on lne 1aor 2a. lf you completed line 5 requesting theinformation be sent to a thnd party, the IRS mustreceive Fom 4506-T within 120 days of the clatesigned by the taxpayer or it will be rejected.Ensure that all applicabla lines are completodbefore signing.

lndividuals. -franscnpts ofjointly filed taxr€turns may be furnished to €ither spouse. Onlyone signature is requtred. Sign Fom 4506-Texactly as your name appeared on $e originalreturn. lr you changed your name. also s gn your

Corporations, Generally, torm 4506'T canbe signed by (l) an officer having legalauthority to bind the coForation, (2) any percondesignated by the board of dnectors or otherqovernrnq body or (3) any ottlcer o'employeeon written request by any principal officer andattested to by the secretary o, olher officer.

Privacy Act and Paperwork Reduction ActNotice. We ask for the information on this formto establish your right to gain access to therequested tax info.mation under the lnternalRevenue Code. We need this information toproperly identify the tax information and rcspondto your request. You are not requrred to requestany transcript; if you do request a transcript,sections 5103 and 6109 and then regulationsrequne you to provde this infomatDn, includrngyour SSN or ElN. lf you do not provide thisinformation, we may not be able to process yourrequest. Provding ralse or fraudulent informationmay subject you to penaltics.

Routine uses or this inrormation includ€ givingat to the Department of Justace for civil andcriminal litigation, and cities, states, the Districtof Columbia. and U.S. commonwealths andpossessioos for use in administeing their taxlaws. We may also disclose this info.mation toother countries under a tax treaty, to federal andstate agencies to enforce federal nontax criminallaws. or to federal law enforcement andintelligence agencies to combat terorism,

You are not req'rired to provide theinformation requested on a fom that as subjectto the PapeNork Reduction Act unless the folmdisplays a valid OMB control number. Books o.records relating to a form or its anstructjonsmust be retained as long as their contents maybecome material in the administration of anylnternal Revenue law. Generally, tax returns andretum information are confid€ntial, as requiredby section 6'103.

The time needed to complete and rile Form4506'T willvary depending on andrvidualcrcumstances The esrmated averade timp is:Learning about the law or the foim, romrn,, PreDarinq the form, l2 mm.. and

,t"fffitl'r'f llo,,.li"" and sendins the rorm

lf you have comments concerning theaccuracy of these tame estimates or suqqestionsfor making Fom 4506-T simpler, we would behappy to hear from you, You can write to

lntemal Revenue SeruiceTax Forms and Publications Division'l-111 Constitution Ave. NW. lR-6526Washington, DC 20224Do not send the form to this address. lnstead,

see Where to ,/e on this page.

Delaware, Distnct ofColumbia, Georgia.lllinois, lndiana,

Hampshi,e New Jersey,

Carolina, Ohio,Pennsylvanra. Rhodelsland. South CarolnaTennessee. Vermont.Virqinja, West Virgjnia,

lnternal Revenue ServiceRAIVS TeamP.O. 8ox 145500Stop 2800 FCincinnati, OH 45250

859-669-3592

Service

Stop 6716 AUSCAustin, TX 73301

512-460-2272

Arkansas, Calirornia,Colorado, Hawaii, ldaho.lllinois, lndiana, lowa,Kansas, Michigan,Minnesota, Montana,Nebraska. Nevada, NewMexico. North Dakota,Oklahoma, Oregon, SouthDakota, Utah,Washington. Wisconsin,

ServiceRAIVS TeamStop 37106Fresno, CA 93a88

559-456-7227

Connecticut. Delaware.D strict of Columbia.Florida, Georgia,Maine, lrlaryland,

Missouri, Neu/ Hampshne,Nuw Jcrscy. New Yor\Nonh Carolrna. Ohro.Pennsylvanla, Rhodelsland, South Carolina,

SeryiceRAIVS TeamStop 67O5 P-6Kansas Cty. MO54999

416-292-6',l02

r ilfffr ilI[]ilfi lllfr lfllflTflfl "''-" vN1P904sT 0410).00

PREFERRED PROVIDER LIST

Listed below are providers of settlement services, some of which we may require you to use.

The charges indicated in the Good Faith Estimate of Settlement Costs are based upon thecorresponding charges of the providers.

NAME AND ADDRESS OF PROVIDER TELEPHONE NATURE OF RELATIONSHIP

TRANS UNION CORP

2 BALDWIN PLACE, PO BOX 1OOO

CHESTER, PAT9O22

EXPERIAN

PO BOX 2002ALLEN, TX 75013

EQUIFAX

PO BOX 740241ATLANTA, GA 30374

KROLL FACTUAL DATA

52OO HAHNS PEAK DRIVE

LOVELAND, CO 80538

(800) 888-4213 SEE BELOW**

(800) 493-10s8 SEE BELOW**

(800) 68s-1111 SEE BELOW**

(800) 765-s600 SEE BELOW**

NORTHEAST M|SSOUR| T|TLE, tNC. (5731754-6225 SEE BELOW**125 NORTH 4TH ST.

LOUISIANA, MO 63353

MEYER TITLE COMPANY344 SOUTH LINCOLN DRIVE

TROY, MO 63379

SERVICELINK

PO BOX 511243LOS ANGELES, CA 90051-3042

(636) s28-8280 SEE BELOW**

(866) 8s4-8941 SEE BELOW* +

*+Lender has repeatedly used the provider in the past 12 months.

Notice Regarding Other Settlement Service ProvidersWe require the use of settlement service providers that are acceptable to us, and we reservethe right to approve or disapprove your selection of any provider of a settlement service. Wedo not maintain a list of the prices of all acceptable settlement service providers.

Revised 2/1/2016

))

OF

LOUISIA]\A

Mortgage Loan Originators & MLO lD Numbers

Ben Logan #537339

James Ross #1150089

CarolTolbert #537325

Bonk of Louisiono = MLO - lD - #525630