Robin Carnahan Secretary of State State of Missouri Securities Division • 600 W. Main • PO Box 1276 Jefferson City, MO 65102 Application for Registration of Single Family Mortgage Revenue Bonds Issued by Missouri Counties, Certain Cities, and the City of St. Louis Pursuant to Sections 108.450 through 108.470 RSMo 1. INFORMATION WITH RESPECT TO THE ISSUER. a. Name of Issuer: b. Address of Issuer: c. Form and date of organization of issuer: d. Name, address and position of all elected officials performing legislative functions for the issuer: e. Name, address and position of chief elected executive officer of issuer: f. Name, address and position of chief appointed fiscal officer of the issuer: g. Do any of the officers or employees of the issuer named above have any material interest in any material transaction with the issuer or any of its agencies as affected within the past three (3) years or proposed to be affected? If the answer is affirmative, please describe such interest or interests in a document attached hereto and marked Exhibit ''A''. 2. INFORMATION WITH RESPECT TO THE BONDS. a. Are the bonds being issued as those described in Sections 108.450 through 108.470 RSMo? b. With respect to the bonds covered by this registration, state the amount of bonds being issued. $ c. Type of offering: (1) Public sale (2) Negotiated sale (3) If the securities will have a proposed offering price, state the proposed maturity schedule and offering price per maturity or the method by which it is to be computed in a document attached hereto and marked Exhibit ''B''. d. Will any portion of the bond issue be offered for sale by the Issuer to any person or class of persons other than underwriters? If so, specify any such person or class and variation in price from the price at which the offer will be made to underwriters and describe the plan of distribution. FORM SR-5 (01-05) American LegalNet, Inc. www.USCourtForms.com e. Will the bonds be offered on any basis other than cash? If so, state the basis other than cash. f. State the estimated aggregate underwriting and selling discounts. $ g. Will any commission or finder's fees be paid with respect to this bond issue other than the underwriting and selling discounts referred to above? If so, state the amount thereof and to whom said commissions or fees will be paid, including separately cash, securities, contracts or anything else of value to accrue to said persons in connection with the offering. h. Will the selling discounts or commissions be variable? their maximum and minimum amounts. If so, state the basis for determining them and i. State the estimated amounts of other selling expenses including legal, engineering, accounting and printing charges. j. State the name and address of the underwriter. k. Is there an underwriting or selling group agreement pursuant to which participation by underwriters in the bond issue is to be made? If so, attach said agreement (or the proposed form of any such agreement whose terms may not have been finally determined) to this registration marked Exhibit ''C''. l. State the estimated cash proceeds to be received by the issuer from the sale of the bonds. $ m. Will the cash proceeds received by the issuer be used for the purpose of making of mortgage loans by mortgage lenders for the construction, rehabilitation or purchase of single family residential housing for low or moderate income persons and families pursuant to Sections 108.450 through 108.470 RSMo? If so, state the numbers of the pages in the preliminary official statement of the issuer in connection with the bond issue for which registration is sought by this application where the following information may be found: (1) USE OF PROCEEDS (a) PURPOSES - The purposes for which the proceeds are to be used by the Issuer: page (b) AMOUNTS - The amounts to be used for each purpose: page (c) PRIORITY - The order or priority for which the proceeds will be used for the purposes stated: page (2) OTHER SOURCES OF FUNDS - The amounts of any funds to be raised from other sources to achieve the purposes stated and the sources of any such funds: page (3) THE TRUSTEE - A description of the trustee: page (4) INSURANCE - A description of the mortgage pool insurance and any other insurance policies relating to the mortgage loans or loans to mortgage lenders: page (5) MORTGAGE PURCHASE AGREEMENTS - A general description of terms and conditions of the purchase of, investment in, or assignment of mortgage loans from mortgage lenders or loans made to mortgage lenders, provisions for the security thereof, and provisions requiring the proceeds of the loans to be used by such mortgage lenders for the making of new mortgages for single family residential housing; provisions for securing such new mortgages; and a general description of the terms and conditions of such new mortgage loans including origination, servicing and administration of the new mortgage loans: page (6) DEFAULT - Events of default and remedies therefor: page (7) UNUSED PROCEEDS - The procedure to be followed in the event that not all of the bond proceeds are able to be used for any reason: page (8) RESERVE FUNDS - Provisions made by the issuer to secure payment of the bonds including the creation of reserve and capitalized interest funds: page FORM SR-5 (01-05) American LegalNet, Inc. www.USCourtForms.com (9) FLOW OF FUNDS - Funds established by the issuer with respect to the setting and collection of principal and interest on mortgages deemed necessary to pay the debt service on the bonds: page (10) ADDITIONAL SECURITIES - Are there provisions permitting or restricting the issuance of additional securities? page (11) RELEASE OR SUBSTITUTION OF ASSETS - Provisions for the release or substitution of assets securing the issue: page (12) MODIFICATION - Modification of terms of the security: page (13) ENFORCEMENT OF RIGHTS OF BONDHOLDERS - The terms and conditions, if any, under which the bondholders, or any specified percentage thereof, of the bonds or any coupons representing interest accrued thereon may, by civil action, compel the Issuer to perform all duties imposed upon it by statute (i.e § 108.450 - § 108.470 of the Revised Statutes of Missouri) and to enforce the performance of any and all of the covenants made by the Issuer with respect to the issuance of the bonds: page (14) MATURITY, ETC. - Provisions relating to the maturity, redemption, amortization, sinking fund or retirement of the bonds: page: (15) ASSUMPTIONS RE: SECURITY - Factual assumptions that were made by the Issuer that must occur to enable it to make full and timely payments of principal, or premiums, if any, and interest on the bonds, service fees, insurance premiums, trustees' fees and the paying agents' fees: page 3. OFFERING STATEMENT - Attach two copies of any preliminary official statement, prospectus, pamphlet, circular, form letter, advertisement, notice of sale, official bid form, or other sales literature intended as of the effective date to be used in connection with the offering and mark it Exhibit “D”. 4. FORM OF BOND - Attach a form of bond, or a specimen bond, or a copy of an actual bond being registered hereby and mark it Exhibit “E”. 5. INDENTURE - Attach a copy of any indenture or other instrument covering the bond to be registered and mark it Exhibit “F”. 6. OPINION OF COUNSEL - Attach a copy of the form of opinion of counsel which will be executed upon delivery of the bonds and which opines as to the legality of the bonds being registered, whether the bonds when, if and as delivered, will be legally issued and, whether the bonds will be a binding obligation of the Issuer. Mark said opinion Exhibit “G”. 7. ORDINANCE - Attach a copy of the ordinance or court order authorizing the issuance of the bonds and mark it Exhibit “H”. 8. ACCOUNTANT'S REPORT, ETC. a. Has any accountant, engineer, appraiser or other person whose profession gives authority to a statement made by him, prepared or certified a report or evaluation which is used in connection with this registration statement and which is not a public record under Section 109.180 of the Revised Statutes of Missouri? b. If so, attach a written consent of such person to examine such report or evaluation and mark it Exhibit ''I''. 9. REGISTRATION IN OTHER STATES. a. List those states in which a registration or similar document in connection with the issuance of these bonds has been or is to be filed. 10. NON-LITIGATION - LEGAL MATTERS. a. Has any adverse judgment, order or decree been entered in connection with the offering of these bonds by the regulatory authorities in any state or by any court, or the Securities and Exchange Commission? If so, list all such judgments, orders or decrees. b. Attach a non-litigation certificate to be executed and delivered at the time of the sale of the bonds and mark it Exhibit “J”. FORM SR-5 (01-05) American LegalNet, Inc. www.USCourtForms.com c. Is there litigation of any nature pending or threatened against the Issuer, as of the date of the registration statement, to restrain or enjoin the issuance, sale, execution or delivery of the bonds or in any way contesting or affecting the validity of the bonds or the security thereof? If so, describe the litigation in a document attached hereto and marked Exhibit “K”. 11. APPOINTMENT OF THE COMMISSIONER OF SECURITIES OF MISSOURI TO RECEIVE SERVICE OF PROCESS. a. With the filing of this application for registration, the Issuer hereby gives its irrevocable consent appointing the commissioner or his successor in office to be its attorney to receive service of any lawful process in any non-criminal suit, action, or proceeding against it or its successor, executor or administrator which arises under this act or any rule or order hereunder after the consent has been filed, with the same force and validity as if served personally upon the Issuer. Date Chief Executive Officer of the Issuer Attest: Subscribed and sworn to me this day of of , State of 20 , in and for the County . My commission expires (Notary Seal) Notary Public Note: Filing Fee—$100.00. Registration Fee—one twentieth of one percent of amount of offering in excess of $100,000.00 in this State up to $900. Maximum total fee—$1000. Please see Missouri regulation 15 CSR 30-50.030. FORM SR-5 (01-05) American LegalNet, Inc. www.USCourtForms.com