AN EXISTING MORTGAGE$ADDRESS OF PROPERTY SECURING LOAN1234Mckenry LaneCITY Los Angeles STATE CA_NOTE: Product and pricing will be determined by statein which property securing loan is located. X Primary residence Second home Investment/rental propertyYou may apply for an individual account regardless of your marital status. This application is _ in your name alone _x_ joint with your spouse, orjoint with a co-applicant who is not your spouse.HomeownersInsuranceCo.Name:NASHPolicy No. 123456789Agent Name:John ElkoAgent Phone No.213-999-0000 FIRSTMIDDLELAST-JRFIRSTMIDDLELAST-JRNAMEDouglasINITIAL NAMEClark- SRNAMESusan INITIALNAMEClark-SRDATESOCIALDATESOCIALOF BIRTH03/8/71SECURITY # 000-00- 1769OF BIRTH02/06/73 SECURITY # 000-00-3985 .MARITAL STATUS.X.MARRIEDUNMARRIED (including single, divorced, and widowed)_ SEPARATEDMARITAL STATUS.X.MARRIEDUNMARRIED (including single, divorced, and widowed)_ SEPARATEDCURRENT CURRENTADDRESS3434 Pitkin Blvd # 110BADDRESSSame #1 10BCITYLos AngelesCOUNTY Los Angeles CITYCOUNTYTIMETIMESTATE CA ZIP 89511 THERE7YRS1 MOS. OWNX.RENTSTATEZIPTHERE YRs1 MOS. OWNX.RENTHOME# DEPENDENTS OTHER HOME# DEPENDENTSPHONE213-888-0000 THAN SELF OR SPOUSEI PHONENOT SHOWN ON LEFT(other than self or spouse) BEST TIME/PLACEBEST TIME/PLACETOCALLYOUMORNING AFTERNOON XEVENING XHOME WORKTOCALLYOU-MORNING_AFTERNOON_EVENING_HOME- WORKPREVIOUSAPTTIMEPREVIOUSAPTTIMECURRENT WORKCURRENTWORKEMPLOYERSelf Employed PHONE213-667-0000 EMPLOYERHousewife PHONEEMPLOYER'SEMPLOYER'SADDRESS 3434 Pitkin Blvd, #110 B ADDRESSCITY Los Angeles STATECAZIP89511 CITYSTATE ZIP(if at currentemployer (If at