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ARTA Lending Consumer & Commercial Sample
Documents Book
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ARTA LendingDocumentation System
ARTA Lending
Documentation System
ARTA Lending Consumer & Commercial Sample Documents Book
ARTA
Lending Consumer & Commercial Sample Documents Book
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ARTA Lending Consumer & Commercial ii Sample Documents Book
Notices
2010 Wolters Kluwer Financial Services.
All rights reserved. Printed in the United States of America.
No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, whether now known or later invented, for any purpose without the prior and express written consent of Wolters Kluwer Financial Services.
Trademarks and Credits
APY Checker, ARTA, and Expere are registered trademarks of Wolters Kluwer Financial Services, Inc. IDFlag is a trademark of Wolters Kluwer Financial Services, Inc. All other trademarks are the property of their respective owners.
General
This publication is provided for training purposes only and does not represent a commitment on the part of Wolters Kluwer Financial Services. It should not be used as a substitute for professional advice in specific situations.
This publication contains examples, screens, and documents for illustrative purposes that may, depending on your institutions state, charter, and/or type, differ from those you encounter in actual use. Information in this publication is subject to change without notice and Wolters Kluwer Financial Services assumes no responsibility for errors.
The software described in this publication is furnished under a license agreement and may be used or copied only in accordance with the terms of the license agreement.
Legal Counsel
In developing this program, printed documentation, and documents, Wolters Kluwer Financial Services has interpreted various laws, regulations, and commentary. Wolters Kluwer Financial Services cannot and does not guarantee that its interpretations are correct except as stated in the accompanying product license agreement.
The following notice is required by law:
Wolters Kluwer Financial Services Products and Services are not a Substitute for the Advice of an Attorney
You are encouraged to seek the advice of your own attorney concerning the use and legality of this program, documentation, and forms. If your or your counsels interpretations are contrary to those presented here, you should, of course, follow your/your counsels interpretations in using the software, documentation, and forms.
Publication Information
ARTA Lending Consumer & Commercial Sample Documents Book
Revision: July 23, 2010
Material ID: 268924
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iii
Table of Contents Alphabetical Listing of Sample Documents .................................................. v
Introduction ........................................................................................ 1
Application Documents........................................................................... 3 UCA: Consumer Credit Application ................................................................... 5 UCA CWS: Consumer Credit Application Worksheet ............................................... 7 OCP1-APP-LAZ: Open-End Credit Loan Application ................................................ 9 INS-FED: Federal Credit Application Insurance Disclosure.......................................11 DN-FCRA-C: Notice of Action Taken .................................................................13 REG-B-NAT: Notice of Action Taken.................................................................15 FCRA-NRA: Notice Regarding Inaccurate Information ............................................17 FCRA-CRA-B: Credit Report Authorization..........................................................19 CLAS: Commercial Loan Application Summary ....................................................21 COMM-APP: Commercial Loan Application .........................................................23 AUTH-ENTITY: Entity Authorization Resolution....................................................25 AUTH-TRUST: Trust Authorization Resolution .....................................................27 CA-1: Corporate Authorization Resolution .........................................................29 LLC-1: Limited Liability Company Authorization Resolution ....................................31 OA-1: Resolution of Lodge ............................................................................33 PR-1: Partnership Resolution of Authority .........................................................35 SPR-1: Sole Proprietorship Resolution of Authority ...............................................37
Consumer Documents .......................................................................... 39 NDaS-SI: Fixed Rate Consumer Loan Agreement (Bank only)....................................41 ND-FEE: Flat Fee Consumer Loan Agreement (Bank only) .......................................45 CL-CU: Variable Simple Interest Note Disclosure, and Security Agreement (Credit Union only) ......................................................................................................49 SA-CONS: Consumer Security Agreement...........................................................55 M-160: Assignment of Account .......................................................................57 OE-TIL-ANT: Truth-in-Lending Disclosure...........................................................59 OL-F-D: Overdraft Fixed Draw Agreement .........................................................61 PL-V-E: Personal Line Variable Evergreen Agreement............................................67 OVERLMTCONLZ: Your Choice Regarding Over-the-Credit Limit Coverage on Your Line of Credit.....................................................................................................73 ADD-CONV-OPT: Conversion Option Addendum ...................................................75 INS-WARN: Federal Sale of Insurance Disclosure ..................................................77 COSIGN-FTC: Notice to Cosigner .....................................................................79 B-IDSTATE: Covered Borrower Identification Statement.........................................81 CROSSCOLLADD: Cross-collateral Addendum ......................................................83
Guaranty Documents ........................................................................... 85 COG: Individual Guaranty of Consumer Loan ......................................................87 M-240: Personal Guaranty for Business Purpose Loan ............................................89 M-250: Corporate Guaranty for Any Purpose Loan ................................................91
Commercial Documents ........................................................................ 93 UN: Universal Promissory Note (Bank only) ........................................................95 MPN-CU: Multi-Purpose Note (Credit Union only).................................................97
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ARTA Lending Consumer & Commercial iv Sample Documents Book
SA-BUS: Commercial Security Agreement ........................................................ 101 LCA: Line of Credit Agreement..................................................................... 103 COMM-AGREE: Commercial Loan Agreement..................................................... 105 COMM-NOTE: Commercial Loan Note ............................................................. 107 COMM-ADD-SA: Commercial Security Agreement ............................................... 109 COMM-ADD-ABF: Asset Based Financing Agreement ............................................ 111 COMM-DMOD: Commercial Debt Modification Agreement ..................................... 113 CERT-9-INFO: Certification of Name and Address............................................... 115 DA: Disbursement Authorization ................................................................... 117 UCC-1-LAZ: National UCC Financing Statement (Model) ....................................... 119 UCC-ADD-LAZ: AddendumUniform Commercial Code Financing Statements ............. 121 UCC-3-LAZ: National UCC Financing Statement Amendment (Model) ....................... 123 UCC1-AUTH: Financing Statement Filing Authorization ........................................ 125 BPA: Business Purpose Affidavit.................................................................... 127 BPS: Business Purpose Statement.................................................................. 129 ARBITRATE-LAZ: Arbitration Agreement.......................................................... 131 CTRL-DEP: Control Agreement for Deposit Accounts ........................................... 135 SBA-ADD: Small Business Administration Lien Instrument Addendum ....................... 137
Food Security Act Documents ...............................................................139 LPB-FSA: Listing of Potential Buyers .............................................................. 141 LPB-VER: Verification of List of Potential Buyers ............................................... 143 NSI-FSA: Notice of Security Interest............................................................... 145
Letter of Credit Documents ..................................................................147 LC-SB-APP: Irrevocable Standby Letter of Credit Application................................. 149 LC-STANDBY: Irrevocable Standby Letter of Credit............................................. 151 LC-SB-REIMB: Irrevocable Standby Letter of Credit Reimbursement Agreement .......... 153
Additional Documents .........................................................................157 AITPP-ADD: Additional Insurance and Third Party Payment Addendum ..................... 159 API-GEN: Agreement to Provide Insurance ....................................................... 161 ATA-PL: Automatic Transfer Authorization ...................................................... 163 BAIL-ACK: Acknowledgement of Possession ...................................................... 165 COLLRCPT-LAZ: Collateral Receipt ................................................................ 167 CTRL-AGREE: Control Agreement .................................................................. 169 DEBTCANCDISC: Debt Cancellation Disclosure ................................................... 171 G-3: Statement of Purpose (Securities)........................................................... 173 LEA: Loan Extension Agreement ................................................................... 175 LIEN-SUB-PP: Personal Property Lien Subordination Agreement ............................. 177 Loan Info Report: Loan Information Report ...................................................... 179 LPCA: Participation Certificate and Agreement................................................. 181 M-170: Assignment of Life Insurance Policy...................................................... 183 MBA-17A: Life Insurance Assignment Questionnaire ............................................ 185 MBA-20 AC-50: Stock Assignment Separate From Certificate ................................. 187 PR-ADD: Preferred Rate Addendum ............................................................... 189 RFA: Request for Advance .......................................................................... 191 SUB-DEBT: Debt Subordination Agreement....................................................... 193 U-1: Statement of Purpose (Stock) ................................................................ 195
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v
Alphabetical Listing of Sample Documents ADD-CONV-OPT: Conversion Option Addendum ..............................................75 AITPP-ADD: Additional Insurance and Third Party Payment Addendum ................ 159 API-GEN: Agreement to Provide Insurance .................................................. 161 ARBITRATE-LAZ: Arbitration Agreement..................................................... 131 ATA-PL: Automatic Transfer Authorization ................................................. 163 AUTH-ENTITY: Entity Authorization Resolution ..............................................25 AUTH-TRUST: Trust Authorization Resolution ................................................27 BAIL-ACK: Acknowledgement of Possession................................................. 165 B-IDSTATE: Covered Borrower Identification Statement....................................81 BPA: Business Purpose Affidavit .............................................................. 127 BPS: Business Purpose Statement............................................................. 129 CA-1: Corporate Authorization Resolution ....................................................29 CERT-9-INFO: Certification of Name and Address.......................................... 115 CLAS: Commercial Loan Application Summary ...............................................21 CL-CU: Variable Simple Interest Note Disclosure, and Security Agreement (Credit
Union only) .................................................................................49 COG: Individual Guaranty of Consumer Loan .................................................87 COLLRCPT-LAZ: Collateral Receipt ........................................................... 167 COMM-ADD-ABF: Asset Based Financing Agreement ....................................... 111 COMM-ADD-SA: Commercial Security Agreement .......................................... 109 COMM-AGREE: Commercial Loan Agreement ............................................... 105 COMM-APP: Commercial Loan Application ....................................................23 COMM-DMOD: Commercial Debt Modification Agreement ................................ 113 COMM-NOTE: Commercial Loan Note ........................................................ 107 COSIGN-FTC: Notice to Cosigner................................................................79 CROSSCOLLADD: Cross-collateral Addendum .................................................83 CTRL-AGREE: Control Agreement............................................................. 169 CTRL-DEP: Control Agreement for Deposit Accounts ...................................... 135 DA: Disbursement Authorization .............................................................. 117 DEBTCANCDISC: Debt Cancellation Disclosure.............................................. 171 DN-FCRA-C: Notice of Action Taken............................................................13 FCRA-CRA-B: Credit Report Authorization ....................................................19 FCRA-NRA: Notice Regarding Inaccurate Information .......................................17 G-3: Statement of Purpose (Securities)...................................................... 173 INS-FED: Federal Credit Application Insurance Disclosure..................................11 INS-WARN: Federal Sale of Insurance Disclosure .............................................77 LCA: Line of Credit Agreement ............................................................... 103 LC-SB-APP: Irrevocable Standby Letter of Credit Application ........................... 149 LC-SB-REIMB: Irrevocable Standby Letter of Credit Reimbursement Agreement ..... 153 LC-STANDBY: Irrevocable Standby Letter of Credit........................................ 151 LEA: Loan Extension Agreement .............................................................. 175 LIEN-SUB-PP: Personal Property Lien Subordination Agreement ........................ 177
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ARTA Lending Consumer & Commercial vi Sample Documents Book
LLC-1: Limited Liability Company Authorization Resolution ...............................31 Loan Info Report: Loan Information Report................................................. 179 LPB-FSA: Listing of Potential Buyers ......................................................... 141 LPB-VER: Verification of List of Potential Buyers .......................................... 143 LPCA: Participation Certificate and Agreement............................................ 181 M-160: Assignment of Account ..................................................................57 M-170: Assignment of Life Insurance Policy................................................. 183 M-240: Personal Guaranty for Business Purpose Loan .......................................89 M-250: Corporate Guaranty for Any Purpose Loan ...........................................91 MBA-17A: Life Insurance Assignment Questionnaire ....................................... 185 MBA-20 AC-50: Stock Assignment Separate From Certificate ............................ 187 MPN-CU: Multi-Purpose Note (Credit Union only) ............................................97 NDaS-SI: Fixed Rate Consumer Loan Agreement (Bank only)...............................41 ND-FEE: Flat Fee Consumer Loan Agreement (Bank only) ..................................45 NSI-FSA: Notice of Security Interest.......................................................... 145 OA-1: Resolution of Lodge .......................................................................33 OCP1-APP-LAZ: Open-End Credit Loan Application ........................................... 9 OE-TIL-ANT: Truth-in-Lending Disclosure .....................................................59 OL-F-D: Overdraft Fixed Draw Agreement ....................................................61 OVERLMTCONLZ: Your Choice Regarding Over-the-Credit Limit Coverage on Your Line
of Credit ....................................................................................73 PL-V-E: Personal Line Variable Evergreen Agreement.......................................67 PR-1: Partnership Resolution of Authority ....................................................35 PR-ADD: Preferred Rate Addendum .......................................................... 189 REG-B-NAT: Notice of Action Taken............................................................15 RFA: Request for Advance ..................................................................... 191 SA-BUS: Commercial Security Agreement ................................................... 101 SA-CONS: Consumer Security Agreement......................................................55 SBA-ADD: Small Business Administration Lien Instrument Addendum .................. 137 SPR-1: Sole Proprietorship Resolution of Authority..........................................37 SUB-DEBT: Debt Subordination Agreement.................................................. 193 U-1: Statement of Purpose (Stock) ........................................................... 195 UCA CWS: Consumer Credit Application Worksheet .......................................... 7 UCA: Consumer Credit Application .............................................................. 5 UCC1-AUTH: Financing Statement Filing Authorization................................... 125 UCC-1-LAZ: National UCC Financing Statement (Model) .................................. 119 UCC-3-LAZ: National UCC Financing Statement Amendment (Model) .................. 123 UCC-ADD-LAZ: AddendumUniform Commercial Code Financing Statements ........ 121 UN: Universal Promissory Note (Bank only) ...................................................95
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Introduction
This document, the ARTA Lending Consumer & Commercial Sample Documents Book, provides representative samples of various consumer and commercial loan documents for users of the ARTA Lending loan documentation software. Samples of various real estate loan documents are provided in the ARTA Lending Residential Real Estate Sample Documents Book, available from Wolters Kluwer Financial Services.
These samples may, depending on your institutions state, charter, and/or type, differ from those you encounter in actual use. Your software may contain state-specific and custom programmed documents that are not represented in this book.
The language on all Wolters Kluwer Financial Services documents and the content of this book are subject to change. These changes are often based on recent statute changes, case law, and lending practices. If such changes directly affect your state, you will receive a software update for ARTA Lending in accordance with your license agreement. If those changes affect documents, you may print new samples.
You are encouraged to seek the advice of your own attorney concerning the use and legality of this book, the documents in it, and our other technical forms. If your or your counsels interpretations are contrary to those presented here, you should, of course, follow your/your counsels interpretations in using the software, documentation, and forms.
The historian, essentially, wants more documents than he can really use.
Henry James
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Application Documents
The following documents are included in this section:
UCA: Consumer Credit Application
UCA CWS: Consumer Credit Application Worksheet
OCP1-APP-LAZ: Open-End Credit Loan Application
INS-FED: Federal Credit Application Insurance Disclosure
DN-FCRA-C: Notice of Action Taken
REG-B-NAT: Notice of Action Taken
FCRA-NRA: Notice Regarding Inaccurate Information
FCRA-CRA-B: Credit Report Authorization
CLAS: Commercial Loan Application Summary
COMM-APP: Commercial Loan Application
AUTH-ENTITY: Entity Authorization Resolution
AUTH-TRUST: Trust Authorization Resolution
CA-1: Corporate Authorization Resolution
LLC-1: Limited Liability Company Authorization Resolution
OA-1: Resolution of Lodge
PR-1: Partnership Resolution of Authority
SPR-1: Sole Proprietorship Resolution of Authority
The historian, essentially, wants more documents than he can really use.
Henry James
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CREDIT APPLICATION
SECTION A - INDIVIDUAL APPLICANT INFORMATION
SECTION B - JOINT APPLICANT OR OTHER PARTY INFORMATION
SECTION C - MARITAL STATUS
AMOUNT REQUESTED
$
FOR HOW LONG PAYMENT DATE DESIRED WANT TO REPAY
MONTHLY
PROCEEDS OF LOAN TO BE USED FOR:
DATE CLASS NO.
ACCOUNT NO.
APPROVED BY
DECLINED BY
FOR CREDITOR USE
SECURED INDIVIDUAL CREDIT - relying solely on my income or assets
UNSECURED INDIVIDUAL CREDIT - relying on my income or assets as well as income or assets from
JOINT CREDIT - We intend to apply for joint credit. (initials)other sources
IMPORTANT: Check ( ) the appropriate boxes below and complete the applicable sections.
Complete only if: for joint credit, for individual credit relying on income or assets from other sources, or applicant is married and resides in a community property state.
NAME (Last, First, Middle)
BIRTHDATE
ADDRESS (Street, City, State & Zip)
PREVIOUS ADDRESS (Street, City, State & Zip) (Complete if less than 3 years at present address)
EMPLOYER (Company Name & Address)
BUSINESS PHONE Ext.
PREVIOUS EMPLOYER (Company Name & Address)
NAME AND ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOU RELATIONSHIP TELEPHONE NO. (Include Area Code)
SOURCES OF OTHER INCOME
Is any income listed in this Section likely to be reduced before the credit request is paid off?
TELEPHONE NO. DRIVER'S LICENSE NO. SOCIAL SECURITY NO. NO. DEPENDENTS AGES OF DEPENDENTS
COUNTY
COUNTY
HOW LONG
HOW LONG
HOW LONG
Do you own
or rent?
Did you own
or rent?
POSITION OR TITLE
SALARY PER MONTH
GROSS: $ NET: $
AMOUNT PER MONTH
$Have you previously received credit from us?
No Yes - When?
AGES OF DEPENDENTSNO. DEPENDENTS
HOW LONG
HOW LONG
HOW LONG
HOW LONG
SOCIAL SECURITY NO.DRIVER'S LICENSE NO.
PRESENT ADDRESS (Street, City, State & Zip)
POSITION OR TITLE
AMOUNT PER MONTH
$
NAME (Last, First, Middle)
BIRTHDATE
RELATIONSHIP TO APPLICANT (If Any)
EMPLOYER (Company Name & Address)
BUSINESS PHONE Ext.
PREVIOUS EMPLOYER (Company Name & Address)
SOURCES OF OTHER INCOME
Is any income listed in this Section likely to be reduced before the credit requested is paid off?
TELEPHONE NO.
Has Joint Applicant or Other Party ever received credit from us?
No Yes - When?
Complete only if: for joint or secured credit, or applicant resides in a community property state or is relyingon property located in such a state as a basis for repayment of the credit requested.
APPLICANT Married Separated Unmarried (including single, divorced, and widowed)
OTHER PARTY Married Separated Unmarried (including single, divorced, and widowed)
No Yes (Explain)
Alimony, child support, separate maintenance received under: Court Order Written Agreement Oral Understanding
No Yes (Explain)
Alimony, child support, separate maintenance received under: Court Order Written Agreement Oral Understanding
GROSS: $ NET: $
SALARY PER MONTH
Federal law requires financial institutions to obtain sufficient information to verify your identity. You may be asked severalquestions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information. Theinformation you provide is protected by our privacy policy and federal law.
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TYPE OF CREDIT REQUESTED
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 income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
IMPORTANT APPLICANT INFORMATION:
(page 1 of 2)1986 Bankers Systems, Inc., St. Cloud, MN Form UCA 6/30/2003-
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SECTION D - ASSET & DEBT INFORMATION
SECTION E - SECURED CREDIT
If Section B has been completed, this Section should be completed giving information about both the Applicant and Joint Applicant or Other Person.Please mark Applicant-related information with an "A". If Section B was not completed, only give information about the Applicant in this Section.
(Including charge accounts, installment contracts, credit cards, rent, mortgages and other obligations. Use separate sheet if necessary.)
CHECKING ACCOUNT NUMBER(S)(where)
SAVINGS ACCOUNT NUMBER(S)(where)
CERTIFICATE OF DEPOSIT(S)(where)
MARKETABLE SECURITIES(issuer, type, no. of shares)
REAL ESTATE(location, date acquired)
LIFE INSURANCE(issuer, face value)
AUTOMOBILES(make, model, year)
OTHER(list)
$
TOTAL ASSETS
$
(Use separate sheet if necessary.)
$
TOTAL DEBTS $$
(OMIT RENT) (OMIT RENT)
$ $ $
LANDLORD OR MORTGAGE HOLDER
AUTOMOBILES(describe)
Rent Payment
Mortgage
Complete the following information about both the Applicant and Joint Applicant or Other Person (if applicable):
Are you obligated to make Alimony, Support or Maintenance Payments? No Yes
If yes, to (Name & Address) Amt. per month $
Are you a co-maker, endorser, or guarantor on any loan or contract? No Yes If yes, for whom? To whom?
Are there any unsatisfied judgments against you? No Yes If yes, to whom owed? Amount $
Have you been declared bankrupt in the last 10 years? No Yes If yes, where? Year?
Complete only if credit is to be secured. Briefly describe the property to be given as security:
PROPERTY DESCRIPTION
NAMES & ADDRESSES OF ALL CO-OWNERS OF THE PROPERTY
IF THE SECURITY IS REAL ESTATE, GIVE THE FULL NAME OF YOUR SPOUSE (if any).
I certify that everything I have stated in this application and on any attachments is correct. Lender may keep this application whether or not it isapproved. By signing below I authorize Lender to check my credit and employment history and to answer questions others may ask Lender about my credit record withLender. I understand that I must update credit information at Lender's request if my financial condition changes.
Applicant's Signature Date Other Signature (Where Applicable) Date
OUTSTANDING DEBTS
DESCRIPTION OF ASSETS NAME IN WHICH THE ACCOUNT IS CARRIED VALUESUBJECT TO DEBT?
ASSETS OWNED
CREDITORNAME IN WHICH
THE ACCOUNT IS CARRIEDACCOUNTNUMBER
ORIGINALAMOUNT
MONTHLYPAYMENTS
PRESENTBALANCE
SIGNATURES-
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1986 Bankers Systems, Inc., St. Cloud, MN Form UCA 6/30/2003- (page 2 of 2)
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CREDIT APPLICATION
SECTION A - INDIVIDUAL APPLICANT INFORMATION
SECTION B - JOINT APPLICANT OR OTHER PARTY INFORMATION
SECTION C - MARITAL STATUS
SECTION D - ASSET & DEBT INFORMATION
SECTION E - SECURED CREDIT
IMPORTANT APPLICANT INFORMATION:
TYPE OF CREDIT REQUESTED
LENDER'S NAME AND ADDRESS
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, separate maintenance received under: Court Order Written Agreement Oral Understanding
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, separate maintenance received under: Court Order Written Agreement Oral Understanding
ASSETS OWNED
DESCRIPTION OF ASSETS NAME IN WHICH THE ACCOUNT IS CARRIED VALUE
CREDITOR ACCOUNT NUMBER NAME THE ACCT. IS UNDER ORIGINAL AMT. PRESENT BAL MO PMTS
OUTSTANDING DEBTS
Applicant Other Party
SIGNATURES -
Federal law requires financial institutions to obtain sufficient information to verify your identity. You may be asked severalquestions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information. Theinformation you provide is protected by our privacy policy and federal law.
Secured Unsecured
Date of Application
Amount $ How Long
Payment Date Desired
Want to Repay Monthly
Purpose
Acct. No. Class
If Section B has been completed, this Section should be completed giving information about both the Applicant and Joint Applicant or Other Person. Please markApplicant-related information with an "A." If Section B was not completed, only give information about the Applicant in this Section.
$
$
$
$
Name Birth Date Tel. No. Soc. Sec. No.
Present Address City State Zip County How Long
Previous Address City State Zip County How Long
Have you applied for credit with us before? No Yes - When? No. Dep. Dep. Ages
Name of Nearest Relative Not Living With You Relationship
Address Tel. No. ( )
Employer (Company Name & Address) How Long
Bus. Tel. Position/Title How Often Paid? Take Home Salary Per Month $
Previous Employer (Company Name & Address) How Long
Sources of Other Income Amount Per Month $
Name Birth Date Tel. No. Soc. Sec. No.
Present Address City State Zip County How Long
Relationship To Applicant (If Any) Have you applied for credit with us before? No Yes - When? No. Dep. Dep. Ages
Name of Nearest Relative Not Living With You Relationship
Address Tel. No. ( )
Employer (Company Name & Address) How Long
Bus. Tel. Position/Title How Often Paid? Take Home Salary Per Month $
Sources of Other Income Amount Per Month $
(Use separate sheet if necessary.)
. . .
Checking Account Number(s)(where)
Savings Account Number(s)(where)
Other Assets(describe)
$
$TOTAL ASSETS
(Include charge accounts, installment contracts, credit cards, rent, mortgages and other obligations. Use separate sheet if necessary.)
Landlord orMortgage Holder
Automobiles
(OMIT RENT) (OMIT RENT)
TOTAL DEBTS
$
$
Rent PaymentMortgage
Complete the following information about both the Applicant and Joint Applicant or Other Person (if applicable):
Are you obligated to make Alimony, Support or Maintenance Payments? No Yes
If yes, to (Name & Address) Amt. Per Month $
Are you a comaker, endorser, or guarantor on any loan or contract? No Yes If yes, for whom? To whom?
Are there any unsatisfied judgments against you? No Yes If yes, to whom owed? Amount $
Have you been declared bankrupt in the last 10 years? No Yes If yes, where? Year?
Complete only if credit is to be secured. Briefly describe the property to be given as security and indicate if others have an ownership interest.
Property Description:
Names & Addresses of all co-owners of the property:
If the security is real estate, give the full name of your spouse (if any):
Complete only if: for joint credit, for individual credit relying on income or assets from other sources, or applicant is married and resides in a community property state.
Married Separated Unmarried* Married Separated Unmarried*
I certify that everything I have stated in this application and on any attachments is correct. Lender may keep this application whether or not it isapproved. By signing below I authorize Lender to check my credit and employment history and to answer questions others may ask Lender about my credit record withLender. I understand that I must update credit information at Lender's request if my financial condition changes.
Individual Credit - relying on my income or assets.
Joint Credit - We intend to apply for joint credit.(initials)
Individual Credit - relying on my income or assetsas well as income or assets from other sources.
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Complete only if: for joint or secured credit, or applicant resides in a community property state or is relying on property located in such a state. (*includes single, divorced and widowed)
(make, model, year)
LAST FIRST M.I.
LAST FIRST M.I.
Applicant's Signature Date Other Signature (Where Applicable) Date
1986 Bankers Systems, Inc., St. Cloud, MN Form UCA/CWS 6/30/2003- (page 1 of 2)
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DO NOT WRITE ON THIS PAGE - CREDITOR WORK SHEETDate Application Received:
Received By:
Approved By: Approved By: Security:
Installment Canadian Rollover Balloon Single Pay Interest Only Principal Reduction Construction Demand
Actual 365 Actual 360 30/360 Precomputed: Simple Rate Add on Rate Discount Rate Split Rate
FIRST PAYMENT PRINCIPAL $
OFFICIALS
PROPERTY INS.
OTHER
INTEREST RATE
$
$
$
$
$
$
$
$
$
$
$
$
$
POINTS NUMBER OF MONTHS NUMBER OF PAYMENTS A YEAR
No Insurance
Single Life & A & H
Yes No
Single Life
Joint Life & A & H
Joint Life
A & H Only
WILL CHANGE: Increase Payment Amount
Increase Amount Due at Maturity
Increase Number of Payments
Points
Above Under
Base Rate:
1. May change as often as
2. Changes in the index rate shall take effect
3. Rate Limitations: maximum minimum
4. Post-Maturity Interest:
CONSUMER BUSINESS Purpose of Loan BUSINESS Business Purpose of Loan
Customer #1 Last First
Customer #2 Last First
Street City
State Zip Note Date Br # Off #
Account # Loan # Renewal #
Business Name
Signatory #1 Title
Signatory #2 Title
Street City
State Zip Note Date Br # Off #
Account # Loan # Renewal #
Unsecured Auto/Property Perfected By Certificate Of Title Mobile Home/Personal Property Residence CD/Savings
Life Insurance Stock/Instruments Perfected By Possession Equipment/Accounts Receivable/Inventory
Personal Business Agriculture
COLLATERAL Will Will not be purchased with proceeds of loan. If Yes, this is a Purchase Money Loan. If this is not a Purchase Money Loan (or
collateral is being taken in addition to that which is purchased) give a brief description of the other collateral
.
- May Cannot
$
$
$
$
ANY ADDITIONAL FORMS WANTED?
Employment Verification Applicant: Position Salary $ Yrs. Employed Source
Employment Verification Other Applicant: Position Salary $ Yrs. Employed Source
Comments:
Residence Verification: Years Comment
Verification:
Creditor and Who Provided Information Date Started Original Bal. Present Bal. Payment Mos. Left to Pay Comments
Total present balance of all outstanding debts ...................
Total net monthly income from all sources ............................
Subtotal ..........................
Subtotal ..........................
Less payment on this proposed loan ....................................
Amount left for all living expenses .......................................
Less rent or mortgage payments.(include 2nd mortgage payments, taxes and insurance) ......
Less payments on all debts not being consolidated.(include monthly support payments) ................................
$
$
$
$
$
$
$
$
IS CAPACITY EVIDENT YES NO
Instructions for completion or reason for turn down:
Address
Address
.
.
.
.
TYPE OF LOAN -
ACCRUAL METHOD -
FUNDING DATE OF LOAN -
MISCELLANEOUSFEES In Cash
PREPAID FINANCECHARGES In Cash Base ChargeFinancedFinanced
CREDIT LIFE INSURANCE -
IS INTEREST RATE VARIABLE?
MINIMUM INTEREST CHARGE - $
USE OF COLLATERAL:
ASSUMPTION
PAY PROCEEDS TO -
CREDITOR
CUSTOMER INFORMATION
COLLATERAL
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- 1986 Bankers Systems, Inc., St. Cloud, MN Form UCA/CWS 6/30/2003(page 2 of 2)
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Individual Credit Line - relying solely on my income Joint Credit Line - We intend to apply for joint credit. (initials)
Individual Credit Line - relying on my income as well as income from other sources
Check
One:
Please answer each question as thoroughly as possible. Provide the following marital status information if: you are applying for joint or securedcredit, or you live in a community property state or are relying on property located in such a state for repayment of the credit requested.
Applicant:
Co-Applicant:
Unmarried (including single, divorced, widowed)
Unmarried (including single, divorced, widowed)
Married
Married
Separated
Separated
Name
Address (include city, state and zip)
Previous Address
Home Phone No.
Taxpayer ID No. Birth Date No. Of Dependents
Employer
Employer's Address
Previous Employer
Name of Nearest Relative
Name of Present Landlord/Mortgage Holder Phone No.
HowLong
HowLong
Business Phone No.
Position
Position
Address
HowLong
Own Rent Mo. Rent/Mortgage $
HowLong
Name
Address (include city, state and zip)
Previous Address
Home Phone No.
Taxpayer ID No. Birth Date No. Of Dependents
Employer
Employer's Address
Previous Employer
Name of Nearest Relative
Name of Present Landlord/Mortgage Holder Phone No.
HowLong
HowLong
Business Phone No.
Position
Position
Address
Own Rent Mo. Rent/Mortgage $
HowLong
HowLong
Source Amount Per (Wk., Mo., or Yr.)
To Whom Paid Credit Limit Mo. Payment
Type Amount
Source Amount Per (Wk., Mo., or Yr.)
To Whom Paid Credit Limit Mo. Payment
Type Amount
NOTE: Married applicants mayapply for separate accounts.
Are you a guarantor or co-maker of any leases, contracts or debts? Yes No
Are there any suits or judgments pending against you? Yes No If yes, state amount $
Have you been declared bankrupt in the last 10 years? Yes No
1.
2.
Location
How Held
Name(s) of Owner(s)
Purchase Price $ Balance Owing $
Location
How Held
Name(s) of Owner(s)
Purchase Price $ Balance Owing $
1.
2.
Location
How Held
Name(s) of Owner(s)
Purchase Price $ Balance Owing $
Location
How Held
Name(s) of Owner(s)
Purchase Price $ Balance Owing $
I certify that everything I have stated in this application and on any attachments is correct. Lender may keep this application whether or not it isapproved. By signing below I authorize Lender to check my credit and employment history and to answer questions others may ask Lender about mycredit record with Lender. I understand that I must update this credit information at Lender's request and if my financial condition changes.
only
PLEASE PRINT
Note: Complete "Other Party Information" if another person will be permitted to use the account, or if the individual applicant is relying onthe income of others as a basis for repayment, or the individual applicant lives in a community property state or is relying on property
located in a community property state as a basis for repayment of the credit requested.
You need not list income from alimony, child support or separate maintenance if you do not want it considered in determining your ability to repay thisobligation. If you do list such income, please provide "Other Party Information" about the person on whom you are relying for such income.
Include any amounts you must pay toward alimony, child support or separate maintenance. Also list all credit card obligations.
Do not include real estate assets. Include cash in savings institutions, stocks, bonds, cash value of life insurance, autos, etc.
Applicant X Date Co-Applicant X Date
If you or co-applicant or other party answers yes to any of the following questions, please explain on backside.
IMPORTANT APPLICANT INFORMATION: Federal law requires financial institutions to obtain sufficient information to verify your identity. You may be asked severalquestions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information. Theinformation you provide is protected by our privacy policy and federal law.
OPEN-END CREDIT LOAN APPLICATION
CO-APPLICANT OR OTHER PARTY INFORMATION
INCOME
OBLIGATIONS
ASSETS
INCOME
REAL ESTATE
OBLIGATIONS
ASSETS
REAL ESTATE
APPLICANT INFORMATION
GENERAL INFORMATION
-1985 Bankers Systems, Inc., St. Cloud, MN Form OCP1-APP-LAZ 8/31/2005
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/ /(page 1 of 1)
Base Employment Income Month
Dividends/Interest, Net Rental Income Month
Other Month
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FEDERAL CREDIT APPLICATION INSURANCE DISCLOSURE
I have applied for an extension of credit with you. You are soliciting, offering, or selling me an insuranceproduct or annuity in connection with this extension of credit.
1.2.
By signing, I acknowledge that I have received a copy of this form on today's date. Unless this disclosure isprovided electronically or I have applied for credit by mail, I also acknowledge that you have provided thisdisclosure to me orally.
........................................................................... ...........................................................................Consumer Date Consumer Date
My purchase of an insurance product or annuity from you or from any of your affiliates; orMy agreement not to obtain, or a prohibition on me from obtaining, an insurance product or annuityfrom an unaffiliated entity.
FEDERAL LAW PROHIBITS YOU FROMCONDITIONING THE EXTENSION OF CREDIT ON EITHER:
2001 Bankers Systems, Inc., St. Cloud, MN Form INS-FED 2/15/2001- (page 1 of 1)
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NOTICE OF ACTION TAKENDate
SSN/TIN
The Federal Equal Credit Opportunity Actprohibits creditors from discriminating against creditapplicants on the basis of race, color, religion,national origin, sex, marital status, age (providedthat the applicant has the capacity to enter into abinding contract); because all or part of theapplicant's income derives from any publicassistance program; or because the applicant has ingood faith exercised any right under the ConsumerCredit Protection Act. The Federal Agency thatadministers compliance with this law concerningthis creditor is:
Regarding your .
We must inform you that:
We are unable to make a decision on your application because it is missing the following information:
.
Please furnish this information to us on or before at the address listed above or we will be unable
We are unable to offer you credit on the terms that you requested, but can offer you credit on the following terms:
.
If this offer is acceptable to you, please notify us on or before at the address listed above.
We are unable to approve your request. Our principal reasons for denying your request are indicated below.
.
We regret that we are unable to approve your request. Your application was processed by a credit scoring system that assigns a numerical value to thevarious items of information we consider in evaluating an application. These numerical values are based upon the results of analyses of repayment histories oflarge numbers of customers. The information you provided in your application did not score a sufficient number of points for approval of the application. Theprincipal reasons why you did not score well compared to other applicants are indicated below.
PRINCIPAL REASONS FOR ADVERSE ACTION CONCERNING CREDIT
Where applicable, our principal reasons for denying your request or reasons you did not score well under the credit scoring system are:
.
If you have any questions regarding this notice, you should contact
. Telephone .
DISCLOSURE OF USE OF INFORMATION OBTAINED FROM AN OUTSIDE SOURCE:
Our credit decision was based in whole or in part on information obtained from an affiliate or from an outside source other than a consumer reporting agency.Under the Fair Credit Reporting Act, you have the right to obtain a disclosure of the nature of this information if you submit a written request to us no laterthan 60 days after you receive this notice.
NOTICE OF RIGHT TO RECEIVE COPY OF APPRAISALYou have the right to a copy of the appraisal report used in connection with your application for credit. If you wish a copy, please write to us at the mailing
address we have provided. We must hear from you no later than 90 days after we notify you about the action taken on your credit application or you withdrawyour application.
In your letter, give us the following information: Loan or application number, if known, date of application, name(s) of loan applicant(s), property address, andyour current mailing address.
Name: Telephone:
Address:
Name: Telephone:
Address:
Our credit decision was based in whole or in part on information obtained in a report from the consumer reporting agency(ies) listed below. However, thereporting agency did not make the decision and is unable to supply you with specific reasons for why we have denied credit to you. You have a right underthe Fair Credit Reporting Act to know the information contained in your credit file at the consumer reporting agency. Under the Fair Credit Reporting Act, youhave the right to obtain a free copy of this report if you submit a written request to the agency(ies) named below no later than 60 days after you receive thisnotice. Under the Fair Credit Reporting Act you also have the right to dispute with the consumer reporting agency the accuracy or completeness of anyinformation in the report.
to give your application further consideration.
Name: Telephone:
Address:
Name: Telephone:
Address:
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(Code numbers, if any,
correspond to the reasons provided on page two of this document):
(page 1 of 2)-1986, 1997 Bankers Systems, Inc., St. Cloud, MN Form DN-FCRA-C 8/16/2004
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ADVERSE ACTION CODESCode 1. Insufficient number of credit references provided. Code 11. Temporary Residence.Code 2. Unacceptable type of credit references provided. Code 12. Unable to verify residence.Code 3. Unable to verify credit references. Code 13. No credit file.Code 4. Income insufficient for amount of credit requested. Code 14. Limited credit experience.Code 5. Excessive obligations in relation to income. Code 15. Poor credit performance with us.Code 6. Unable to verify income. Code 16. Bankruptcy.Code 7. Temporary or irregular employment. Code 17. Lack of established earnings record.Code 8. Unable to verify employment. Code 18. Value or type of collateral not sufficient.Code 9. Length of employment. Code 19. Slow or past due in trade or loan payments.Code 10. Length of residence. Code 20. Delinquent past or present credit obligations with others.
Code 21. Collection action or judgment.Code 22. Garnishment or attachment.Code 23. Foreclosure or repossession.Code 24. Number of recent inquiries on credit bureau report.
(page 2 of 2)-1986, 1997 Bankers Systems, Inc., St. Cloud, MN Form DN-FCRA-C 8/16/2004
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NOTICE OF ACTION TAKENDate
SSN/TIN
The Federal Equal Credit Opportunity Act prohibitscreditors from discriminating against creditapplicants on the basis of race, color, religion,national origin, sex, marital status, age (providedthat the applicant has the capacity to enter into abinding contract); because all or part of theapplicant's income derives from any publicassistance program; or because the applicant has ingood faith exercised any right under the ConsumerCredit Protection Act. The Federal Agency thatadministers compliance with this law concerningthis creditor is:
Dear
Thank you for your Application for .
Based upon your Application we must inform you that:
We are unable to make a decision on your Application because it is missing the following information:
.
Please furnish this information to us on or before at the address listed above or we will be unable
We are unable to offer you credit on the terms that you requested, but can offer you credit on the following terms:
.
If this offer is acceptable to you, please notify us on or before at the address listed above.
If checked, our principal reasons for denying your original request are indicated below.
We are regrettably unable to approve your request. Our principal reasons for this decision are indicated below.
Where applicable, the following are our principal reasons for taking adverse action:
Insufficient number of credit references provided.
Unacceptable type of credit references provided.
Unable to verify credit references.
Income insufficient for amount of credit requested.
Excessive obligations in relation to income.
Unable to verify income.
Temporary or irregular employment.
Unable to verify employment.
Length of employment.
Length of residence.
Temporary residence.
Unable to verify residence.
No credit file.
Limited credit experience.
Poor credit performance with us.
Number of recent inquiries on credit bureaureport.
Other, Specify:
.
If you have any questions regarding this notice, you should contact .
Telephone .
NOTICE OF RIGHT TO RECEIVE COPY OF APPRAISALYou have the right to a copy of the appraisal report used in connection with your application for credit. If you wish a copy, please write to us at the mailing
address we have provided. We must hear from you no later than 90 days after we notify you about the action taken on your credit application or you withdrawyour application.
In your letter, give us the following information: Loan or application number, if known, date of application, name(s) of loan applicant(s), property address, andyour current mailing address.
Name:
Address:
Telephone:
Our credit decision was based in whole or in part on information obtained in a report from the consumer reporting agency listed below. However, the reportingagency did not make the decision and is unable to supply you with specific reasons for why we have denied credit to you. You have a right under the FairCredit Reporting Act to know the information contained in your credit file at the consumer reporting agency. Under the Fair Credit Reporting Act, you have theright to obtain a free copy of this report if you submit a written request to the agency named below no later than 60 days after you receive this notice. Underthe Fair Credit Reporting Act you also have the right to dispute with the consumer reporting agency the accuracy or completeness of any information in the report.
to give your Application further consideration.
Delinquent past or present creditobligations with others.
Our credit decision was based in whole or in part on information obtained from an affiliate or from an outside source other than a consumer reporting agency.Under the Fair Credit Reporting Act, you have the right to obtain a disclosure of the nature of this information if you submit a written request to us no laterthan 60 days after you receive this notice.
Collection action or judgment.
Garnishment or attachment.
Foreclosure or repossession.
Bankruptcy.
Value or type of collateral not sufficient.
Lack of established earnings record.
Slow or past due in trade or loan payments.
Name:
Address:
Telephone:
Name:
Address:
Name:
Address:
Telephone:
Telephone:
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DISCLOSURE OF USE OF INFORMATION OBTAINED FROM AN OUTSIDE SOURCE:
-1986 Bankers Systems, Inc., St. Cloud, MN Form REG-B-NAT 11/8/2004 (page 1 of 1)
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As a participant in the consumer reporting system, we furnish information about ourexperience with you to consumer reporting agencies. These consumer reports allow us to makecredit and other opportunities available to you. If you believe that we have furnishedinformation to a consumer reporting agency that is inaccurate please notify us at the followingaddress and identify the specific information that is inaccurate.
NOTICE REGARDING INACCURATE INFORMATION
1997 Bankers Systems, Inc., St. Cloud, MN Form FCRA-NRA 5/15/97- (page 1 of 1)
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CREDIT REPORT AUTHORIZATION
Business Entity
Date Savings Account #Tax ID # Checking Account #Customer # Loan #Other Services
As used in this document, the words "you" and "your" mean the individual signers listed below and the words "we" and "us"mean the financial institution.
We need to verify your creditworthiness for the following reason(s):
The above-named Business Entity with which you are associated has applied for a loan from us.The above-named Business Entity with which you are associated has applied to open a deposit or share account with us.
.
You understand that we have a current need to review your creditworthiness as an individual. By signing below, you authorize usto check your credit account and employment history and/or have a credit reporting agency prepare a credit report on you. Youalso acknowledge that we will verify the creditworthiness of the above-named Business Entity.
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(Signature) (Date)
(Name/Title) (Identifying Information) (Name/Title) (Identifying Information)
(Signature) (Date)
(Name/Title) (Identifying Information)
(Signature) (Date)
(Name/Title) (Identifying Information)
(Signature) (Date)
-2000 Bankers Systems, Inc., St. Cloud, MN Form FCRA-CRA-B 11/20/2000 (page 1 of 1)
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COMMERCIAL LOAN APPLICATION - SUMMARY
Financial Summary
Equal Credit Opportunity Notice
Additional Information RequestedProfit and Loss
General Information
Loan Request
(See page 2 for explanation)
Creditor's Name and Address
Liabilities
Applicant's Name and Address
Assets
IMPORTANT APPLICANT INFORMATION:
NOTICE - JOINT CREDIT:
Current Liabilities
Long Term Liabilities
Other Liabilities
Total Liabilities
Net Worth (Total Assets minus Total Liabilities)
Total Liabilities and Net Worth
Are Any Returns Being Contested or Audited: Yes No
Financial Statement Submitted with this Summary. Current Financial Statement on File with Creditor.
Amount Requested $
Purpose of Loan Terms
Legal Relationship:
Authorization Resolution Dated:
Income Tax Return Filed Through What Date:
Name of Accountant or Accounting Firm:
Names of Persons Authorized to Borrow Money on Behalf of and in the Name of the Applicant:
Corporation Partnership Sole-Proprietorship Other
Submitted with Statement On File With Creditor To Be Provided
Yes No
Date
Telephone #
Taxpayer I.D.#
Nature of Business
Business Year End Date
Were your gross revenues $1,000,000 or less in your previous fiscal year?
Date of Birth - (for individuals only)From
Current Assets
Account/Trade Receivables
Inventory - Gross
Fixed Assets
Other
Total Assets
NOTICE: The Federal Equal Credit Opportunity Act prohibits creditors fromdiscriminating against credit applicants on the basis of race, color, religion,national origin, sex, marital status, age (providing the applicant has thecapacity to enter into a binding contract), because all or a part of theapplicant's income derives from any public assistance program; or because theapplicant has in good faith exercised any right under the Consumer CreditProtection Act. The federal agency that administers compliance with this lawconcerning this creditor is:
Net Sales
Gross Profit
Net Operating Profit
Net Profit/Loss
Secured Unsecured Initial Request Additional Advance
If you answered "yes" and the Creditor denies your application for credit, youhave the right to a written statement of the specific reasons for the denial. Toobtain the statement please contact:
within 60 days from the date you are notified of Creditor's decision. TheCreditor will send you a written statement of reasons for the denial within 30days of receiving your request for the statement. The notice at right describesadditional protections extended to you.
Federal law requires financial institutions to obtain sufficient information to verify your identity. You may be asked severalquestions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information.The information you provide is protected by our privacy policy and federal law.
We intend to apply for joint credit. (initials)
To
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CLAS 12/12/2007VMPC109 (0712).00
Page 1 of 2Initials:
Commercial Loan Application SummaryVMP Bankers SystemsWolters Kluwer Financial Services 1995, 2007
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CALIFORNIA NOTICE
Current Assets -
Account/Trade Receivables -
Inventory-Gross -
Fixed Assets -
Total Assets -
Current Liabilities -
Long Term Liabilities -
Total Liabilities -
Net Sales -
Gross Profit -
Net Operating Profit -
Net Profit or Loss -
Gross Revenues -
For transactions secured by real property:
Cash, marketable securities, accounts receivable - trade (net), inventory (net) and other current assets.
All current accounts and notes and deferred notes, less reserve for bad debts.
Value of finished goods, work in progress and raw materials.
Net value of all land, buildings, machinery, equipment, fixtures, furniture, etc.
All current assets, receivables, inventory, fixed assets and amounts due from officers and employees, investments, deferral/prepaid expenses,
1.
2.
3.
4.
5.cash surrender value of life insurance policies and others.
Bank notes payable, other trade notes payable, accounts payable-trade, other accounts payable, due to officers and employees,taxes-income other, accrued expenses, long term debt due within one year, other current liabilities.
6.
Notes, bonds, and mortgages and other accounts coming due in one year or more.
All current, long term and other liabilities.
All sales less discounts, charge-backs and allowances.
Net sales less the cost of goods sold.
7.
8.
9.
10.
Gross profit less: expenses, (selling, general and administrative, interest, depreciation), officer's compensation, provision for bad debtand other expenses.
11.
Net operating profit, plus other income, less federal, state and local taxes.12.
Value of all sales and services provided prior to deducting discounts, charge backs and allowances. This amount is requested to determineApplicant's rights and Creditor's obligations under the Equal Credit Opportunity Act. The term has no exact accounting definition and Creditor will rely on valueprovided by Applicant.
Hazard Insurance exceeding the replacement value of the real property is not required as a condition of this loan.
13.
This information and the information provided on all accompanying financial statements and schedules is provided for the purpose of obtaining credit for theApplicant(s) or for the purpose of Applicant(s) guaranteeing credit for others. Applicant(s) acknowledge that representations made in this statement will be reliedon by Creditor in its decision to grant such credit. This Statement is true and correct in every detail and accurately represents the financial condition of theApplicant(s) on the date given below. Creditor is authorized to make all inquiries it deems necessary to verify the accuracy of the information contained herein andto determine the creditworthiness of the Applicant(s). Applicant(s) will promptly notify Creditor of any subsequent changes which would affect the accuracy ofthis Statement. Creditor is further authorized to answer any questions about Creditor's credit experience with Applicant(s). Applicant(s) are aware that anyknowing or willful false statements regarding the value of the above property for purposes of influencing the actions of Creditor can be a violation of federal law,18 U.S.C. & 1014, and may result in a fine or imprisonment or both.
In addition, each individual signing below authorizes the Creditor to check their individual credit account and employment history and have a credit reportingagency prepare a consumer credit report on them.
By signing below, the undersigned agree(s) to all the terms and conditions beginning on page 1 through the bottom of page 2 of this Application.
By
BySignature Date
Signature DateBy
Signature Date
BySignature Date
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CLAS 12/12/2007VMPC109 (0712).00
Page 2 of 2Initials:
Commercial Loan Application SummaryVMP Bankers SystemsWolters Kluwer Financial Services 1995, 2007
DEFINITIONS
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COMMERCIAL LOAN APPLICATION
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New Joint application (Identify other applicants)
Refinance/Consolidation Loan Number(s), Balance, and Lender's Name:
Renewal/Extension (No New Advances)
Renewal with New Advance
Other Modification (Explain)
Date Received By
Action Taken: Approved Declined Rejected
Date Reviewed By
Action Taken: Approved Declined Rejected
Date Notified By
Notification Sent: In Person Telephone Letter
To:
Legal Name Organizational Form, Where and When Organized (ex., Corporation, Delaware, 1984)
Franchise, in full force and without defaults, with (Name of Franchiser)
Name(s) of Affiliated Entities
Current Tradename(s) Other Tradenames Used in Last 10 Years
Local Address Principal Executive Office Address
Phone No: Phone No:
Fax No: Fax No:
Tax Identification Number Nature of Business NAICS Code
Principals' Names, Addresses, Position Titles, Social Security Numbers and Date of Birth - (for individuals only)
Accountant Name, Address, and Phone Number
Financial Statements. (Check all that apply and attach statements to this application.)
Fiscal Year Calendar Year
Financial Statements covering to
Accounts Receivable Schedule covering to
Inventory Schedule covering to
Income Tax/Informational Returns for tax years
Other (Specify)
Other Statements. (Check all that apply and attach statements to this application.)
Business Plan dated
Project Plans & Specifications Project Budget dated
Franchise Agreement, FTC Franchiser Disclosure Statement
List of outstanding judgments or threatened lawsuits, arbitration, or other proceeding against loan applicant.
Other (Articles of Incorporation, Resolutions, etc.)
Amount Requested $
Commercial Purpose Loan
Agricultural Purpose Loan
Use of Proceeds (Brief Description of Intended Use):
Loan Payment (Choose One)
Principal and Interest
Principal, plus Interest
Interest Only
Single Payment
Other (describe)
Loan Advances (Choose One)
Single Advance/Closed End
Revolving Draw Loan
Draw Loan
Construction/Permanent Loan
Revolving Draw Construction Loan
Draw Construction Loan
Requested Payment Amount $ with Balloon $
Requested First Payment Date Requested Loan Term
Payment Frequency (if Installment) Monthly Quarterly Semi-Annually Other (describe)
Requested Interest Rate Fixed Variable Index (If Variable)
List of primary and secondary sources of repayment for this loan:
For Internal Use Only
2. LOAN REQUEST AND SOURCES OF REPAYMENT.
1. LOAN APPLICANT. Loan Applicant General Information.
1998 Bankers Systems, Inc., St. Cloud, MN Form COMM-APP 3/23/2004- (page 1 of 2)
IMPORTANT APPLICANT INFORMATION: Federal law requires financial institutions to obtain sufficient information to verify your identity. You may be asked severalquestions and to provide one or more forms of identification to fulfill this requirement. In some instances we may use outside sources to confirm the information. Theinformation you provide is protected by our privacy policy and federal law.
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4. LOAN GUARANTY. The requested loan will be guaranteed. (Complete this section if checked)
3. LOAN SECURITY. The requested loan will be secured. (Complete this section if checked)
EQUAL CREDIT OPPORTUNITY NOTICE:
NOTICE - JOINT CREDIT:
CREDIT DENIAL NOTICE.
X
X
SIGNATURES.
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The federal Equal CreditOpportunity Act prohibits creditors from discriminating against creditapplicants on the basis of race, color, religion, national origin, sex,marital status, age (providing the applicant has the capacity to enterinto a binding contract), because all or a part of the applicant'sincome derives from any public assistance program, or because theapplicant has in good faith exercised any right under the ConsumerCredit Protection Act. The federal agency that administerscompliance with this law concerning this creditor is:
We intend to apply for joint credit. (initials)
All loan proceeds will be for purchase of collateral.
Description of purchase money collateral:
$ of the proceeds will be for purchase of collateral.
Appraised value of purchase money collateral $
Brief description of non-purchase money collateral:
Appraised value $
Liens on collateral (List any collateral with liens on it, the amount of underlying debt, the names and addresses of collateral's lienholders)
Non-Applicant owners of collateral. Attach a separate list with name(s), address(es), and phone number(s) of any other owner(s) of the
owner(s) of the collateral.
Description of current property insurance on existing collateral
Type: Deductible:
Coverage: Term:
Legal name
Address
Phone No:
Guarantor Financial Statements. If checked, Guarantor is an entity and will provide financial statements upon request by Lender.
Security. Brief description of collateral to secure this guaranty
Appraised value of guaranty collateral $
Liens on collateral (List any collateral with liens on it, the amount of underlying debt, and the names and addresses of collateral's lienholders):
Non-Guarantor owners of collateral. If checked, attach a separate list with the name(s), address(es), and phone number(s) of any other
Guarantor or affiliate were declared bankrupt within the last 10 years.
There are outstanding judgments against Guarantor. (Attach Summary)
On a separate sheet, list each threatened or pending lawsuit,arbitration, or other proceeding and its amount claimed.
Description of current property insurance on non-purchase money collateral
Type: Deductible:
Coverage: Term:
collateral.
In addition, each individual signing below authorizes the Creditor to check their individual credit account and employment history and have a creditreporting agency prepare a consumer credit report on them.
within 60 days from the date you are notified of our decision. Wewill send you a written statement of reasons for the denial within 30days of receiving your request for the statement. The notice thatfollows describes additional protections extended to you.
If your gross revenues were $1,000,000or less in your previous fiscal year, or you are requesting tradecredit, a factoring agreement, or similar types of business credit inthis Commercial Loan Application, and if your application forbusiness credit is denied, you have the right to a written statementof the specific reasons for the denial. To obtain the statement pleasecontact (Name, address, and telephone number of the person oroffice from which the statement of reasons can be obtained):
By
By
Applicant Name
Title
Title
Date
Date
for Applicant
for Applicant
By signing below, Loan Applicant submits this application and the information provided on all accompanying financial statements andschedules for the purpose of obtaining credit and represents that the information submitted is accurate and complete. Loan Applicant acknowledgesthat representations made in this application will be relied on by Lender in evaluating this application and, if approved, in extending credit. LoanApplicant represents that none of the parties named in this application have relied on advice from the Lender in applying for or receiving any credit.Loan Applicant acknowledges that Lender has not made any commitment to approve this application and extend credit, unless otherwise agreed toin writing. Lender is authorized to conduct any inquiries it decides are necessary to verify the accuracy of the information contained in thisapplication and to use any reasonable method to determine the creditworthiness of the Loan Applicant. Lender is also authorized to answer anyquestions from others about Lender's credit experience with the parties in this application. Loan Applicant will promptly notify Lender of anysubsequent changes which would affect the accuracy of this application, and will provide all documents and information that Lender decides arenecessary to complete this application. Loan Applicant authorizes Lender to retain this application, whether or not Lender approves any extension ofcredit. Any intentional misrepresentation of the information contained herein could result in criminal action under federal law.
1998 Bankers Systems, Inc., St. Cloud, MN Form COMM-APP 3/23/2004- (page 2 of 2)
For Internal Use Only
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ENTITY AUTHORIZATION
NOT FOR CONSUMER PURPOSES
(Indicate a, b, c, d, e and/or f to exercise each specific power):
AUTHORIZATIONS FOR ENTITIES
SPECIFIC AUTHORIZATIONS.
ENTITY CERTIFICATIONS.
GENERAL AUTHORIZATIONS.
(a)
(b)
(c)
(d)
(e)
(f)
Individual's Name, Title, & if applicable,Representative Entity's Name and Relationship to Authorizing Entity
Signature or Facsimile Signature
Authorizing Entity authorizes and directs the designated Agents to act, as indicated, on Authorizing Entity's behalf to:
Open or close any share or deposit accounts in Authorizing Entity's name, including, without limitation, accounts such as
share draft, checking, savings, certificates of deposit or term share accounts, escrow, demand deposit, reserve, and
overdraft line-of-credit accounts. Number of signatures required .
Enter into and execute any preauthorized electronic transfer agreements for automatic withdrawals, deposits or transfers
initiated through an electronic ATM or point-of-sale terminal, telephone, computer or magnetic tape using an access device
like an ATM or debit card, a code or other similar means. Number of signatures required .
Enter into and execute commercial wire transfer agreements that authorize transfers by telephone or other communication
systems through the network chosen by Financial Institution. Number of signatures required .
Endorse for cash, deposit, negotiation, collection or discount by Financial Institution any and all deposit checks, drafts,
certificates of deposit and other instruments and orders for the payment of money owned or held by Trust. Number of
signatures required .
Sign checks or orders for the payment of money, withdraw or transfer funds on deposit with you. Number of signatures
required .
Enter into and execute a written night depository agreement, a lock-box agreement or a safe deposit box lease agreement.
Number of signatures required .
Borrow money or obtain other credit or financial accommodation from Financial Institution on behalf of and in the name of
Authorizing Entity on the terms agreed to with Financial Institution. The designated Agents may execute and endorse
Institution) is designated to provide Authorizing Entity the financial accommodations indicated in this Authorization, subject to the Financial Institution'srules and regulations from time to time. All prior transactions obligating Authorizing Entity to Financial Institution by or on behalf of Authorizing Entityare ratified by execution of this Authorization. Any Agent, while acting on behalf of Authorizing Entity, is authorized, subject to any expressedrestrictions, to make all other arrangements with Financial Institution which are necessary for the effective exercise of the powers indicated within thisAuthorization. The signatures of the Agents are conclusive evidence of their authority to act on behalf of Authorizing Entity. Unless otherwise agreedto in writing, this Authorization replaces any earlier related Authorization and will remain effective until Financial Institution receives and records anexpress written notice of its revocation, modification or replacement. Any revocation, modification or replacement of this Authorization must beaccompanied by documentation, satisfactory to Financial Institution, establishing the authority for the change. Authorizing Entity agrees not to combineproceeds from collateral securing any debts owed to Financial Institution with unrelated funds.
The following persons (Agents) are authorized to act on behalf of Authorizing Entity in fulfilling the purposes of thisAuthorization:
Authorizing Entity operates or owns or leases property. Authorizing Entity has the power and authority to provide this Authorization, to confer thepowers granted in this Authorization and to carry on Authorizing Entity's business and activities as now conducted. The designated Agents have thepower and authority to exercise the actions specified in this Authorization and Authorizing Entity properly adopted these authorizations and appointedthe Agents and me to act on its behalf. Authorizing Entity will notify Financial Institution before reorganizing, merging, consolidating, recapitalizing,dissolving or otherwise materially changing ownership, management or organizational form. Authorizing Entity will be fully liable for failing to notifyFinancial Institution of these material changes.
I, , certify that: I am a/the
designated to act on behalf of
(Authorizing Entity). Authorizing Entity is a
and its Taxpayer Identification Number . I am authorized and directed to execute an
original or a copy of this Authorization to Financial Institution, and anyone else requiring a copy. Authorizing Entity is duly organized, validly existing
and in good standing under the laws of and is duly qualified, validly existing and in good standing in all jurisdictions where
Authorizing Entity conducts business and other activities under the additional trade name or fictitious name of
and Authorizing Entity has the legal power and authority to use this trade name or
fictitious name. Authorizing Entity will not use any trade name or fictitious name without Financial Institution's prior written consent and will
preserve Authorizing Entity's existing name, trade names, fictitious names and franchises.
I certify Authorizing Entity authorizes and agrees that: (Financial
Authorizing Entity has adopted any facsimile signatures indicated above. Financial Institution may rely on those facsimile signatures that resemble thespecimens within this Authorization or the specimens that Authorizing Entity periodically files with Financial Institution, regardless of by whom or bywhat means the signatures were affixed.
-2000 Bankers Systems, Inc., St. Cloud, MN Form AUTH-ENTITY 4/30/2003
(Authorization Signer's name)
(Authorization Signer's title)
(type of entity, like a "non-profit" corporation)
(page 1 of 2)
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AUTHORIZATION'S SIGNERS:
INTERPRETATION.
All Debts.
Specific Debts.
All Debts.
SIGNATURES.
Specific Debts.
FOR FINANCIAL INSTITUTION USE ONLYFOR FINANCIAL INSTITUTION USE ONLY
Pennsylvania.
-2000 Bankers Systems, Inc., St. Cloud, MN Form AUTH-ENTITY 4/30/2003
(describe)
(specify)
Name Attest: Name
(describe)
(page 2 of 2)
Whenever used, the singular includes the plural and the plural includes the singular. The section headings are for convenience only
and are not to be used to interpret or define the terms of this Authorization.
All debts, liabilities and obligations of every type and description owed now or in the future by Authorizing
Entity to Financial Institution.
Number of signatures required .
Receive and acknowledge receipt for funds, whether payable to the order of Authorizing Entity or an Agent, without
additional certification as to the use of the proceeds. Number of signatures required .
Guaranty the payment and performance of debts, liabilities and obligations owed to Financial Institution or its successors and
assigns by (Borrower):
The debts, liabilities and obligations, and their renewals, extensions, refinancing and modifications,
evidenced by :
All debts, liabilities and obligations, and their renewals, extensions, refinancing and modifications, that
Borrower owes now or in the future to Financial Institution, to the extent allowed by law.
Number of signatures required .
The designated Agents may also grant a security interest, lien or other encumbrance to Financial Institution in any or all real
or personal property that Authorizing Entity now owns or may acquire in the future for the payment or performance of this
guaranty. Number of signatures required .
Periodically amend, restructure, renew, extend, modify, substitute or terminate any agreements or arrangements with
Financial Institution that relate to this Authorization. Number of signatures required .
Execute other agreements that Financial Institution may require, and perform or cause to be performed any further action
necessary to carry out the purposes of this Authorization. Number of signatures required .
Other .
Number of signatures required .
By:
By signing, I certify and agree to the terms contained in this Authorization on behalf of Authorizing Entity on
. I also acknowledge receipt of a copy of this Authorization.
Grant a security interest, lien or other encumbrance to Financial Institution in any or all real or personal property that
Authorizing Entity now owns or may acquire in the future for the payment or performance of:
The debts, liabilities and obligations, and their renewals, extensions, refinancing and modifications,
evidenced by :
Acct/Loan # Authorization and agreement completed and effective .
By for the Financial Institution.
Acct/Loan # Authorization and agreement completed and effective .
By for the Financial Institution.
By:
promissory notes, acceptances or other evidences of indebtedness. If checked, the maximum outstanding credit limit for
all available credit and financial accommodation to Authorizing Entity from Financial Institution must not exceed
$ . Number of signatures required .
The designation of an Agent does not create a power of attorney; therefore, Agents are not subject to the provisions of 20 Pa.C.S.A.
Section 5601 et seq. (Chapter 56; Decedents, Estates and Fiduciaries Code) unless the agency was created by a separate power of attorney. Any
provision that assigns Financial Institution rights to act on behalf of any person or entity is not subject to the provisions of 20 Pa.C.S.A. Section 5601
et seq. (Chapter 56; Decedents, Estates and Fiduciaries Code).
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TRUST AUTHORIZATION
Name and Address of 2nd Successor TrusteeName and Address of 1st Successor Trustee
2001 Bankers Systems, Inc., St. Cloud, MN Form AUTH-TRUST 4/30/2003
(Name Of Trust)
(check one)
(describe)
Signature or Facsimile SignatureIndividual's Name, Title, & if applicable,Representative Entity's Name and Relationship to Trust
Trust authorizes and directs the designated Trustee to act, as indicated, on Trust's behalf to:
The undersigned,
(Trustee), certify that: the undersigned is/are the current Trustee(s), designated to act on behalf of
, Taxpayer Identification Number (Trust). The
beneficiaries of this Trust are named in the Trust Documentation on file are as follows:
. Trustee is authorized and directed to execute an original or a copy of this Authorization to
Financial Institution, and anyone else requiring a copy. This Trust is duly organized, validly existing and in good standing under the laws of
, and is duly qualified, validly existing and in good standing in all jurisdictions where Trust operates or owns or leases
I certify Trust authorizes and agrees that: (Financial Institution) is
designated to provide Trust the financial accommodations indicated in this Authorization, subject to the Financial Institution's rules from time to time.
Trustee is authorized to act on behalf of Trust in fulfilling the purposes of this Authorization:
The debts, liabilities and obligations, and their renewals, extensions, refinancing and modifications,
evidenced by :
All debts, liabilities and obligations of every type and description owed now or in the future by Trust to
Financial Institution.
Number of signatures required .
property. Trust has the power and authority to provide this Authorization, to confer the powers granted in this Authorization and to carry on Trust'sactivities as now being conducted. If Trustee is unable or unwilling to serve as Trustee, then any of the following (in the order indicated) may serve asa successor trustee and will become the Trustee on providing Financial Institution with properly authenticated signature or facsimile signature ondocumentation that is satisfactory to Financial Institution.
Open or close any share or deposit accounts in Trust's name, including, without limitation, accounts such as share draft,
checking, savings, certificates of deposit or term share accounts, escrow, demand deposit, reserve, and overdraft
line-of-credit accounts. Number of signatures required .
Enter into and execute any preauthorized electronic transfer agreements for automatic withdrawals, deposits or transfers
initiated through an electronic ATM or point-of-sale terminal, telephone, computer or magnetic tape using an access device
like an ATM or debit card, a code or other similar means. Number of signatures required .
Enter into and execute commercial wire transfer agreements that authorize transfers by telephone or other communication
systems through the network chosen by Financial Institution. Number of signatures required .
Endorse for cash, deposit, negotiation, collection or discount by Financial Institution any and all checks, drafts, certificates
of deposit and other instruments or orders for the payment of money owned or held by Trust.
Number of signatures required .
Sign checks or orders for the payment of money, withdraw or transfer funds on deposit with you.
Number of signatures required .
Enter into and execute a written night depository agreement, a lock-box agreement or a safe deposit box lease agreement.
Number of signatures required .
Borrow money or obtain other credit or financial accommodation from Financial Institution on behalf of and in the name of
Trust on the terms agreed to with Financial Institution. The designated Trustee may execute and endorse promissory notes,
acceptances or other evidences of indebtedness. If checked, the maximum outstanding credit limit for all this credit and
financial accommodation to Trust from Financial Institution must not exceed $ .
Number of signatures required .
Grant a security interest, lien or other encumbrance to Financial Institution in any or all real or personal property that Trust
now owns or may acquire in the future for the payment or performance of:
(a)
(b)
(c)
(d)
Trust has adopted any facsimile signatures indicated above. Financial Institution may rely on those facsimile signatures that resemble the specimenswithin this Authorization or the specimens that Trust periodically files with Financial Institution, regardless of by whom or by what means thesignatures were affixed.
(page 1 of 2)-
(Indicate a, b, c and/or d to exercise each specific power):
TRUST CERTIFICATIONS.
GENERAL AUTHORIZATIONS.
SPECIFIC AUTHORIZATIONS.
NOT FOR CONSUMER PURPOSES
Specific Debts.
All Debts.
AUTHORIZATION FOR TRUSTS
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