Table of Contents

Atlas Mobile Home Directory

Mobile/Manufactured Home Loan Application

Name

Address

City

State

Zip code

Home Phone

E Mail Address

Employer

Length of Employment

Work Phone #

Monthly Income

Previous Employer

Length of Employment

Co-Applicant's Information

Name

Home Phone #

Employer

Work Phone #

Monthly Income

Information on home you want to purchase

Year home was built

Manufacturer

Model

Size of home

Type of Loan Request

New Singlewide

New Doublewide

New Triplewide

Used Singlewide

Used Doublewide

Used Triplewide

Refinance

Debt Consolidation

Purchase

Requested Loan Amount

Payoff on home

Current Monthly Payment

Current Interest Rate

Current Lender

I certify that the information I have provided is true and correct. I authorize Atlas Mobile Home Directory and lending affiliate Aaron Financial Services to verify any information included in this application or in other documents required to obtain the loan I am requesting. I also authorize any party named in this application to provide any and all information to Atlas Mobile Home Directory and lending affiliate Aaron Financial Services.

Application may be printed if you feel uncomfortable about sending it over the Internet. Fax completed application to (800) 898-1491

Applicant Signature ____________________________________

Co-Applicant Signature _________________________________

Date ________________ 200__

Reach Aaron Financial Services at (800) 768-1616