Agent Loan Application/Underwriting Checklist

1 OSigned and Completed loan Application**oLast 3 years applicant s Federal Income Tax Returns (Both Individual and Business, if applicable)oLast 3 years selling agency Business Tax ReturnsoLast 3 years December year-end selling agency Business Metrics Reports in Excel Format (reports should include all agency numbers beingpurchased)oMost recent selling agency Business Metrics Report in Excel Format (report should include all agency numbers being purchased)oLast 3 years December year-end selling agency Compensation Summary Reports (DASH-Compensation App.)oMost recent selling agency Summary Premium Report for Termination Payment (TPP) in Excel Format (include Vested and In Vesting TPPreports for all agency numbers being purchased)oMost recent selling agency Agent Achievement Program Report screenshot (DASH-Dashboards tab)oCurrent ResumeExisting Agents with Allstate Purchase.

2 *oSigned and Completed loan Application**oLast 3 years applicant s Federal Income Tax Returns (Both Individual and Business, if applicable)oLast 3 years selling agency Business Tax ReturnsoLast 3 years December year-end applicant and selling agency Business Metrics Reports in Excel Format (reports should include all applicableagency numbers)oMost recent applicant and selling agency Business Metrics Reports in Excel Format (reports should include all applicable agency numbers)oLast 3 years December year-end applicant and selling agency Compensation Summary Reports (DASH-Compensation App)oMost recent applicant and selling agency Summary Premium Reports for Termination Payment (TPP) in Excel Format (include Vested and InVesting TPP reports for all applicable agency numbers)oMost recent applicant and selling agency Agent Achievement Program Report screenshot (DASH-Dashboards tab)Existing Agents with Allstate Refinance and/or Line of Credit.

3 OSigned and Completed loan Application**oLast 3 years applicant s Federal Income Tax Returns (Both Individual and Business, if applicable)oLast 3 years December year-end applicant agency Business Metrics Reports in Excel Format (reports should include all agency numbers)oMost recent applicant agency Business Metrics Report in Excel Format (report should include all agency numbers)oLast 3 years December year-end applicant agency Compensation Summary Reports (DASH-Compensation App)oMost recent applicant agency Summary Premium Report for Termination Payment (TPP) in Excel Format (include Vested and In Vesting TPPreports for all agency numbers)oMost recent applicant agency Agent Achievement Program Report screenshot (DASH-Dashboards tab)Please mail or email these documents to:Wintrust Agent Finance9701 W.

4 Higgins Rd., Suite 330 Rosemont, Illinois 60018 855-552- loan 2021 Wintrust Agent Finance * Agents considering the purchase of an existing insurance agency are encouraged to consult with their attorney to ensure the purchasing Agent is adequately protected by an appropriate non-competition agreement from the selling loan Application/Underwriting ChecklistBelow are the documents needed to apply for a loan . New Agents to Allstate Purchase:**Forms provided; signatures required on top of page 1, page 4, top of page 6, and page 8 TERM loan AND LINE OF CREDITAGENT loan APPLICATIONCityCountyStateZipPrevious Home Address (if at current address < 2 years): _____CityCountyStateZipHome Phone: _____Personal Email Address: _____Cell Phone: _____Preferred Contact Method: _____Fax: _____ Date of Birth: _____Driver's License #: _____State Issued: _____Driver's License Issue Date: _____Driver's License Expiration Date: _____How many years of insurance experience do you have?

5 _____How many years with Allstate? _____Are you a licensed Allstate Agent ? _____ Securities Licenses: 6_____ 63_____ 7 _____Are you an approved Allstate agency buyer?_____ If yes, when were you approved?_____Have you acquired any books of business in the last 12 months? _____ If yes, how many? _____AGENCY INFORMATION (APPLICANT S AGENCY OR AGENCY TO BE ESTABLISHED)Legal Name of Agency: _____Agency Address: _____CityCountyStateZipTax Identification Number: _____ Type (S Corp, C Corp, Sole Prop, LLC, LLP): _____ State of Organization: _____ Has your Agency Type ever changed?

6 (If yes, provide details): _____ _____ Name of all entity Officers: _____Work Phone: _____ Work Email Address: _____Work Fax: _____ Agency # (Include all): _____Year agency was established: _____Length of your ownership: _____Do you have any debt on your agency? _____ If yes, what is the amount? _____Lender Name: _____ loan Maturity: _____ loan Rate: _____How many licensed staff do you employ? _____ How many unlicensed staff? _____(Please include yourself in the count)Once application is completed along with all accompanying documents (Questions call 855-552- loan (5626)):Mail to: Wintrust Agent Finance Attn: loan Underwriting (Confidential), 9701 W.

7 Higgins Rd., Suite 330, Rosemont, Illinois 60018 or email to ensure overnight delivery please use Federal Express vs. US Post Office Express MailFIN773-12 Page 1 Wintrust Agent Finance is a division of Lake Forest Bank & Trust Company, INFORMATIONName: _____ SSN: _____ Current Home Address: _____INDIVIDUAL ACCOUNTWe intend to apply for joint credit (if applicable)Co-Applicant Signature JOINT ACCOUNTA pplicant Signature 9701 W. Higgins Rd., Suite 330, Rosemont, Illinois 60018855-552- loan (5626)nSinglenMarriedLO AN INFORMATIONR equested Term loan Amount $ _____ Requested loan Term (years): 3 _____5_____ 7_____ 10_____ Requested Line Amount ($25,000 - $100,000) $_____ loan Purpose: _____ _____ For purchase transactions, select most appropriate situation: Initial Office _____ New Satellite _____ Merge into existing office _____ Anticipated loan Closing Date: _____ Describe assets being offered as collateral, including current estimated value.

8 _____ _____ _____ Is agency pledged to another financial institution or individual? If yes, then explain: _____ _____ Purchase Price of Agency Book: _____ Amount of Down Payment $_____ Explain source of down payment: _____ _____ How did you hear about this Lending Program? _____ _____ Please answer the following questions about your financial records. If the answer to any question is yes, please attach you: n Separated n DivorcedDo you have any tax liens or contested taxes?nYesnNoHave you ever been convicted of a felony?nYesnNoAre you a defendant in any suits or legal actions?

9 NYesnNoHas the applicant or any guarantorever obtained credit under another name?nYesnNoIf yes, please explain: _____ _____ _____ _____nYesnNonYesnNoDoes the applicant or guarantor have taxobligations, including payroll and sales taxes, past due?Have you ever filed for or taken bankruptcy, composition, settlement or assignment for benefit of creditors?Page 2 FIN773-12 Wintrust Agent Finance is a division of Lake Forest Bank & Trust Company, AND EDUCATION HISTORYWORK EXPERIENCE:(Include 20 years of employment or last 5 employers. If more space is needed, provide an attachment.)

10 Employer NameEDUCATION:High SchoolCollegeOtherAddressSchool NamePosition/TitleYear CompletedDates of EmploymentPage 3 FIN773-12 CERTIFICATE OF BENEFICIAL OWNER(S)To help the government fight financial crime, federal regulation requires certain financial institutions to obtain, verify and record information about the beneficial owners of legal entity customers. Legal entities can be abused to disguise involvement in terrorist financing, money laundering, tax evasion, corruption, fraud and other financial crimes. Requiring the disclosure of key individuals who own or control a legal entity ( , the beneficial owners) helps law enforcement investigate and prosecute these crimes.