REQUEST FOR VERIFICATION OF DEPOSIT Applicant____________________ Address______________________ City_________________________ Loan No._____________________ Escrow No.___________________ Gentlemen: I have applied for a [form of loan] loan to be made by [name of lending institution] I shall appreciate your completing the Deposit Verification for their confidential use and forwarding it to: [name of institution] Statement of Account [address] Type of Account [city,state,zip] ____________________ Balance ____________________ Date ____________________ Thank you for your consideration and prompt reply, as it will avoid many delays. Very truly yours, ________________________ VERIFICATION OF BANK OR OTHER DEPOSITORY Is Statement Above Approximately Correct? If "No", please give Current Balance $_____________ Date Account Opened_____________________ Approximate Average Balance for Past 2 Months $________ Loans Outstanding To Applicant: Secured Date of Loan__________ Current Balance ________ Unsecured Date of Loan__________ Current Balance_______ This information is furnished to you in strict confidence in response to your request and is solely for use by you in connection with the above application for a loan. ____________ _________________________ _______________________ Date Official Title Signature