<p> 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</p><p>Personal Financial Statement</p><p>Last Year Gross: Average Monthly Gross:</p><p>Last Year Net: Average Monthly Net:</p><p>CASH ON HAND Amt. In Personal Checking Acct: Amt. In Personal Savings Acct:</p><p>Amt. In Business Acct: Amt. In Stocks/Bonds/Mutual Funds:</p><p>OTHER MONTHLY EXPENSES Insurance: Number Of Employees:</p><p>Payroll: Repairs/Maintenance:</p><p>ASSETS/LIABILITIES Description: (Auto/Equipment: Make/Model: Home: Address) Date Purchased Purchase Price Market Value Amount Owed Monthly Payment</p><p>1</p><p>2</p><p>3</p><p>4</p><p>5</p><p>6</p><p>7</p><p>8</p><p>9</p><p>10</p><p>11</p><p>12</p><p>13</p><p>14</p><p>15</p><p>16</p><p>17</p><p>18</p><p>19</p><p>20</p><p>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.</p><p>Signature: Print: Date: </p>