East West Bank Bank Statement Form – Fill Out and Use This PDF

Financial Statement

Reason for default: ____________________________ Servicer’s Loan Number: __________________

Property Address: _____________________________________________________________________

Do you intend to keep the property? _______________________________________________________

Is the property listed for sale? □ Yes □ No Are there other liens on the property? □ Yes □ No

Borrower Name: ________________________________ Social Security Number: ________________

Mailing address: ______________________________________________________________________

Total number of persons living at this address: ____	Number of dependents at this address: _______
Home Phone:_______________________________	Work Phone: ___________________________

Co-Borrower Name: ___________________________ Social Security Number: ___________________

Mailing Address: ______________________________________________________________________

	Total number of persons living at this address: ____					Number of dependents at this address: _______
	Home Phone: _______________________________					Work Phone: ___________________________
	Have you contacted credit counseling services? □ Yes □ No						Number of cars you own: ___________
	Monthly Income (Borrower)						Monthly Income (Co-Borrower)
	Gross Wages	$				Gross Wages		$
	Unemployment Income	$				Unemployment income		$
	Child Support/Alimony	$				Child Support/Alimony		$
	Disability Income	$				Disability Income		$
	Rental Income	$				Rental Income		$
	Other	$				Other		$
	Less: Federal & State Tax, FICA	$				Less: Federal & State Tax, FICA		$
	Less: Other Deductions	$				Less: Other Deductions		$
	(401k, etc.)					(401k, etc.)
	Total	$					Total	$
	Monthly Expenses (All Borrowers		)			Assets and Liabilities (All Borrowers			)
	Other Mortgages, Liens, Rents	$				Checking Accounts		$
	Auto Loan(s)	$				Savings / Money Market		$
	Auto Expenses / Insurance	$				Stocks, Bonds and CD’s		$
	Credit Cards & Installment	$				IRA / Keogh Accounts		$
	Loans
	Health Insurance	$				401K / ESOP / Accounts		$
	Medical	$				Home		$
	Child Care / Child Support /	$				Other Real Estate		$
	Alimony
	Food / Spending Money	$				Cars with No Liens		$
	Water / Sewer / Utilities / Phone	$				Other		$
	Other	$				Other		$
	Total	$					Total	$

I(we) agree that the financial information provided is an accurate statement of my(our) financial status. I,(we) understand and acknowledge that any action taken by the lender of my(our) mortgage loan on my(our) behalf will be made in strict reliance on the financial information provided. My(our) signature(s) below grants the holder of my(our) mortgage the authority to confirm the information I(we) have disclosed in this financial statement to verify that it is accurate by ordering a credit report and to contact my real estate agent and/or credit counseling representative (if applicable). By signing below, I(we) advise you that if I/we should hereafter agree to a repayment plan for my/our mortgage loan, reinstate my/our mortgage loan, or pay off my/our loan in full then, by doing so and without the necessity of any further action on my/our part, I/we hereby expressly withdraw this request for a loan workout. In that event, I/we hereby direct you to take no further action to process the request for a workout.

Borrower’s Signature: ____________________________________________	Date: ______________
Co-Borrower’s Signature: _________________________________________	Date: ______________

Before mailing, make sure you have signed and dated this form; include copies of your two most recent pay stubs and bank statements of your checking and/or savings account. If you are self-employed, attach a copy of the past six-month’s profit and loss statement, along with your most recent Federal Tax returns.

Rev. 2/12/08

9300 Flair Drive, 5th Floor, El Monte, CA 91731, Tel. 877.392.6868 – Nasdaq: EWBC