MBS Financial Commercial Finance Group P.O. Box 1755 1 N. Jefferson Ave. West Jefferson , NC 28694 Office: 336-219-0105 Fax: 336-217-8155

Personal Financial Statement

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I authorize MBS Financial to obtain any information that may be required concerning the statements contained in this application, and agree that the application will remain the property of MBS Financial whether or not the lease is granted. I hereby certify that all statements contained in this application are true and complete and are made for the purpose of obtaining credit. I agree to notify you of any material changes in the condition of affairs, and this statement shall be construed by MBS Financial to be a continuing statement of the condition of the Lessee until written notice of there contrary is received by MBS Financial. Lessee and principal authorize the release of credit information to the Lessor.

Signature: Print: Date: