Form 114

Schedule C - Sale Leaseback

State the reasons for entering into this type of transaction.

Please Complete The Following:

Original Value Book Value Appraised Value Sale Price

Please give the date the institution acquired the property

Briefly describe the lease terms. Attach a copy of the proposed lease with this application

Include copy of independent appraisal OF LEASE

Is the lessor, either directly or indirectly, providing financing to enable the lessee to acquire the property? If yes, please detail the credit arrangements.

State any options that either party may exercise regarding this transaction