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INCOME VERIFICATION FORM <br /> If the total asset value exceeds $5,000, perform the calculations in the following table. If the total asset value <br /> is less than $5,000, the amount of investment income to be included in annual household income is $0. <br /> Calculation of Investment Income to be Included in Annual Household Income <br /> 1. Total Annual Household Investment Income $ <br /> 2. Total Asset Value $ x 10% $ <br /> The Greater of#1 or#2 : Investment Income to be Included in Annual Household Income $ <br /> Calculation of the Household's Total Annual Income <br /> Total Annual Household Gross Earned Income $ <br /> Total Investment Income to be Included in Annual Household Income $ <br /> Total Household Income $ <br /> Documentation <br /> Attach True Copies of the Relevant Documents Listed Below <br /> Paycheck stubs from three most recent <br /> pay periods Bank/Savings account verification <br /> Employment verification Self-employment verification <br /> Three years Income tax returns for Title <br /> Holders Unemployment verification <br /> Social security verification Welfare verification <br /> Alimony/child support verification Disability income verification <br /> Other (Describe) <br /> Page 68 <br /> Exhibit E <br /> 55394.OD 101\43423340.1 <br />