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10/17/2007 WED 15:15 FAX 6127823302 Canon 6670 <br />Nanne and address Winona na owner: <br />Dl ne purchased. <br />Anoouut of down payment <br />Who currently holds the niongle— name and address: <br />'I-ernr of nuirtgage: <br />Rate of iatcrast On morn mt�c <br />Stam monthly paymant at which the: morutge and/or <br />contrac! Al decd is lion" it.luideted: - <br />Polellaseprice: _ <br />,Amount of Contract for Deed: <br />Who ctn udy holds wand for deed -- name and address: <br />"berms of Contract for Deed: <br />Rtac of interest. on Contract for 1)oed: <br />An the payments on the mortgage and/or contrail Word <br />up to date? yes No <br />MW the Mrtouu of tha Uvanntent to 1W applicant has in the WAY= premiss, fr wres, linuione, stoclun Ulde, etc. <br />( Ailach supportmg proof of the seu ce of such mosey) <br />Give the Pull names, domof-hirti, ad4cmes, telephone numbers ofall persons, other than the applicant, who have any <br />financial iutercSi in the Won, buildings, prer»iscs, Gxhnes; Hmtiture, w stock in trade. Stale the natnre of the interest <br />amount thereof, and the haus for payrocnt for or other reiutborsemani. (17hi.s shall include, bot notbe limited lo, any, <br />lessees, lessors, mor(gagors, lenders, lien holders, n'aslees, hustois and persmts who have cosigned notes or otherwise <br />lo[med, plad.gcd, or extended securipy for any indebtedness of the applicant.) A release form is necessary for all persons <br />Niro have financial intetost in dte. business. <br />Fall Ni nte:: Fi <br />