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					EXHIBIT A MONTANA BOARD OF HOUSING MORTGAGE CREDIT CERTIFICATE (MCC) PROGRAM

APPLICATION FOR MCC RESERVATION LENDER _________________________________ Address City Lender Code MORTGAGOR___________________________ Property Address City ________________, Zip Code____________ County

The following are enclosed with this Application for MCC Reservation: LENDER USE 1. 2. 3. 4. o o o o o o Copy of the Loan Application Copy of the Sales Contract signed by all parties Verification of current Gross Annual Family Income Executed Notice of Potential Benefits Provided by a Mortgage Credit Certificate (Exhibit F) Executed Notice of Reservation Refund Fee Guideline (Exhibit D) Executed Recapture Notice to Mortgagor (Exhibit G) MBOH USE 1. 2. 3. 4. o o o o o o

5. 6.

5. 6.

MCC RESERVATION REQUEST (to be completed by Lender) Date Requested Existing housing o; or New construction o Mortgage Loan Rate %

Reservation Loan Amount $

Mortgage Loan Term Lender Contact Signature

Lender Contact Phone Number MCC RESERVATION CONFIRMATION (to be completed by MBOH) Date Reserved MCC Number

MBOH Authorized Signature

MCC—2003 MBOH Form 210 Revised 2/03