TO: Applicant_____________________

Address_______________________

City__________________________

Loan No.______________________

Escrow No.____________________

Gentlemen:

I have applied for a real estate loan to be made by Chambers Savings and Loan Association.

I shall appreciate your completing the Employer’s Verification below for their confidential use and forwarding it to:

______________________________________________________________________________________

Thank you for your consideration and prompt reply, as it will avoid many delays.

Very truly yours,

__________________________

Applicant

EMPLOYER’S VERIFICATION

1. Entered your employ: _________________________________

2. Present Position: ____________________________________

3. Present Monthly Salary: Gross Monthly Salary: _____

Overtime: _________________

Bonus or Commission: ______

How paid: _________________

4. If Applicant is in Military Service please report income on a monthly basis as follows:

Base Pay_______________ Quarters and Subsistence______________

Flight or Hazard Allowance____________

5. Probability of Continued Employment__________________

6. Does Employee have Re-employment rights for :

Sick Leave? ______ Maternity Leave? _________

7. Other Remarks: _______________________________________

The above is furnished in strictest confident to your request.

Date________________ Employer_______________