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Credit Application

IMPORTANT

Please read these directions before completing this Application, and select the appropriate item below:*

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

To help the government fight the funding of terrorism and money laundering activities, the USA Patriot Act requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, physical address, date of birth, taxpayer identification number and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents. We will let you know If additional information is required.

SECTION A - INFORMATION REGARDING APPLICANT

IF U.S. PERSON (Complete all that apply)
IF NON-U.S. PERSON (Complete all that apply)

Additonal Applicant Information

Present Employer

Previous Employer

Income

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation
Alimony, child support, or separate maintenance received under:

Have you ever received credit from us?
Is any income listed in this Section likely to be reduced before the credit is paid off?

Nearest Relative not living with you:


COVERED BORROWER IDENTIFICATION STATEMENT

Federal Law provides important protections to active duty members of the Armed Forces and their dependents. To ensure that these protections are provided to eligible applicants, we require you to sign one of the following statements as applicable:

- OR -

Warning: It is important to fill out this form accurately. Knowingly making a false statement on a credit application is a crime.

By signing or electronically signing below, I certify that the box checked above accurately represents my current status as a covered borrower under the John Warner National Defense Authorization Act.

SECTION B - INFORMATION REGARDING CO-APPLICANT

IF U.S. PERSON (Complete all that apply)
IF NON-U.S. PERSON (Complete all that apply)

Additonal Applicant Information

Present Employer

Previous Employer

Income

Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation

ALIMONY, CHILD SUPPORT OR SEPARATE MAINTENANCE RECEIVED UNDER:
Have you ever received credit from us?

COVERED BORROWER IDENTIFICATION STATEMENT

Federal Law provides important protections to active duty members of the Armed Forces and their dependents. To ensure that these protections are provided to eligible applicants, we require you to sign one of the following statements as applicable:

- OR -

Warning: It is important to fill out this form accurately. Knowingly making a false statement on a credit application is a crime.

By signing or electronically signing below, I certify that the box checked above accurately represents my current status as a covered borrower under the John Warner National Defense Authorization Act.

SECTION C - MARITAL STATUS (Do not complete if this is an Application for individual unsecured credit)

APPLICANT
OTHER PARTY

SECTION D - ASSET & DEBT INFORMATION

All Applicants complete this section. If there is more than one applicant, mark Primary Applicants Information with an A. If Section B was not completed, only give information about the Applicant in this Section.

Automobiles

Cash Value of Life Insurance

Real Estate

Marketable Securities

Other

IF U.S. PERSON (Complete all that apply)







IF U.S. PERSON (Complete all that apply)

Auto Insurance

ARE YOU THE CO-MAKER, ENDORSER OR GUARANTOR ON ANY LOAN OR CONTRACT? *

Properties

Co-Owners (list all)

SIGNATURES

Everything that I have stated in this Application is correct to the best of my knowledge. I understand that you will retain this Application whether or not it is approved. You are authorized to check my credit and employment history and answer questions about your credit experience with me. Unless I have purchased the insurance product(s) by mail or if the Credit Disclosures are provided electronically, by signing below, I acknowledge that I have received the Credit Disclosures orally at the time I applied for credit and fully understand the disclosures noted above. I am also being provided with a copy of these disclosures and I acknowledge receipt by my signature.

CREDIT DISCLOSURES: An insurance product or annuity may be offered to you. If you purchase an insurance product or an annuity: (1) The insurance product or annuity is not a deposit or other obligation of, or guaranteed by, this institution or our affiliate(s); (2) With exception of Federal Flood Insurance or Federal Crop Insurance, the insurance product or annuity is not insured by the Federal Deposit Insurance Corporation or any other agency of the United States, this institution, or our affiliate(s); and (3) In the case of an insurance product or annuity that involves an investment risk, there is investment risk associated with the insurance product, including the possible loss of value. If an insurance product or annuity is offered we cannot condition an extension of credit on either of the following: (1) Your purchase of an insurance product or annuity from us or any of our affiliates; or (2) Your agreement not to obtain, or a prohibition on you from obtaining, an insurance product or annuity from an unaffiliated entity.

Thank you for your submission.
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