Applicant's Name and Address FINANCIAL STATEMENT Creditor's Name and Address TYPE OF CREDIT - CHECK THE APPROPRIATE BOX Individual - Provide your financial information only Joint, with Information on separate financial statement Relationship Business or Occupation Employer's Name and Address INDIVIDUAL INFORMATION Business or Occupation Employer's Name and Address JOINT PARTY INFORMATION Length of Employment Home Phone of Birth Bus. Phone S.S./Taxpayer I.D.# Length of Employment Home Phone of Birth Bus. Phone S.S./Taxpayer I.D.# ASSETS Note: Complete SCHEDULES first. LIABILITIES Cash On Hand and in Banks Sched. A Notes Due to Banks Sched. A Cash Value of Life Insurance Sched. B Notes Due to Relatives and Friends Sched. H U.S. Gov. Securities Sched. C Noted Due to Others Sched. H Other Marketable Securities Sched. C Accounts and Bills Payable Sched. H Real Estate Owned Mortgages and Contracts Owned Notes and Accounts Receivable - current TOTAL LIQUID ASSETS Sched. E Sched. F Sched. D Loans on Life Insurance Policies Contract Accounts Payable Cash Rent Payable Other Liabilities Due within 1 Year - Itemize Sched. B Sched. H Notes and Accounts Receivable - over 90 days Sched. D TOTAL SHORT TERM LIABILITIES Notes Due From Relatives and Friends Sched. D Real Estate Mortgages Payable Sched. E Other Securities - Not Readily Marketable Sched. C Liens and Assessments Payable Personal Property Sched. G Other Debts - Itemize IRA and Tax Deferred Accounts Other Assets - Itemize l (see attached itemization) Total Liabilities TOTAL ASSETS TOTAL PRODUCTIVE ASSETS ANNUAL INCOME Net Worth (Total Assets Minus Total Liabilities) TOTAL LONG TERM LIABILITIES TOTAL LIABILITIES AND NET WORTH ESTIMATE OF ANNUAL EXPENSES Salary Bonuses and Commissions $ Income Taxes $ Dividends and Interest $ Other Taxes $ Rental and Lease Income (Net) $ Insurance Premiums $ Alimony, child support, or separate maintenance income need not be revealed if you Mortgage Payments $ do not wish to have it considered as a basis for repaying this obligation. Other Income - Itemize $ Rent Payable $ Provide the following information only if Joint Credit is checked above. Other Expenses $ Other Person's Salary, Bonuses and Commissions $ 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. Other Income of Other Person - Itemize $ TOTAL GENERAL INFORMATION TOTAL CONTINGENT LIABILITIES Are any Assets Pledged Other Than Described on SCHEDULES l yes l no As Endorser, Co-maker or Guarantor l yes l no Are You a Defendent in Any Suits or Legal Actions? l yes l no On Leases or Contracts l yes l no Income Tax Return Filed Through What? Legal Claims l yes l no Have you ever been declared Bankrupt in the last 10 years? l yes l no Federal - State Income Taxes l yes l no Are you a Partner or Officer in any other Venture? l yes l no Other SCHEDULES A CASH IN BANKS AND NOTES DUE TO BANKS (List all Real Estate Loans in Schedule E) Additional Information Requested NAME OF BANK Type of Account Type of Ownership On Deposit Notes Due Banks Collateral (if Any) and Type Of Ownership $ $ l See Attached Itemization Cash On Hand TOTALS - Bankers Systems, Inc., St. Cloud, MN Form FS 11/1/2000
B LIFE INSURANCE (List only those Policies that you own) COMPANY Face Of Policy Cash Surrender Value Policy Loan From Insurance Co. Other Loans Policy As Collateral BENEFICIARY C l See Attached Itemization TOTALS $ $ SECURITIES OWNED (Including U.S. Gov't Bonds and all other Stocks and Bonds) DESCRIPTION Type of Indicate those Not Registered in Your Name Ownership COST Face Value-Bonds No. Of Shares Stock Market Value U.S. Gov. Sec. Market Value Marketable Sec. MARKET VALUE Not Readily Marketable Amount Pledged To Secured Loan D l See Attached Itemization TOTALS $ $ $ NOTES AND ACCOUNTS RECEIVABLE (Money Payable or Owed to You Individually-Indicate % of your Ownership Interest Balance Due Balance Due Bal. Due Notes MAKER/DEBTOR % When Due Original Amount Current Accounts Over 90 Days Rel. and Friends $ $ $ $ Security (If Any) E l See Attached Itemization TOTALS $ $ $ REAL ESTATE OWNED (Indicate % of your Ownership Interest) Original Present Value Amount of TITLE IN NAME OF % Description and Location Acquired Cost of Real Estate Ins. Carried $ $ $ MORTGAGE OR CONTRACT PAYABLE Bal. Due Payment Maturity l See Attached Itemization TOTAL $ TOTAL $ F MORTGAGES AND CONTRACTS OWNED (Indicate % of your Ownership Interest) MAKER Cont. Mtg. % Name Address PROPERTY COVERED Starting Payment Maturity Balance Due $ G l See Attached Itemization TOTALS $ PERSONAL PROPERTY (Indicate % of your Ownership Interest) Cost Value LOANS ON PROPERTY DESCRIPTION % When New When New Today Balance Due To Whom Payable l See Attached Itemization TOTALS $ H NOTES ACCOUNTS AND BILLS AND CONTRACTS PAYABLE Other Obligors Notes Due To Notes Due "Others" Accounts Contracts PAYABLE TO (If Any) When Due Rel. and Friends (Not Banks) and Bills Payable COLLATERAL (If Any) Payable l See Attached Itemization TOTALS This information and the information provided on all accompanying financial statements and schedules is provided for the purpose of obtaining credit for the Applicant(s) or for the purpose of Applicant(s) guaranteeing credit for others. Applicant(s) acknowledge that representations made in this Statement will be relied on 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 the Applicant(s) on the date given below. You are authorized to make all inquiries you deem necessary to verify the accuracy of the information contained herein and to determine the creditworthiness of the undersigned. Applicant(s) will promptly notify Creditor of any subsequent changes which would affect the accuracy of this Statement. Creditor is further authorized to answer any questions about Creditor's credit experience with Applicant(s). Applicant(s) are aware that any knowing 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. sec. 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 reporting agency prepare a credit report on them. The undersigned declares that he/she has read and understands the statements above. Signed Signature Signature Other Person (If Applicable) - Bankers Systems, Inc., St. Cloud, MN Form FS 11/1/2000
FEDERAL CREDIT APPLICATION INSURANCE DISCLOSURE I have applied for an extension of credit with you. You are soliciting, offering, or selling me an insurance product or annuity in connection with this extension of credit. FEDERAL LAW PROHIBITS YOU FROM CONDITIONING THE EXTENSION OF CREDIT ON EITHER: 1. My purchase of an insurance product or annuity from you or from any of your affiliates; or 2. My agreement not to obtain, or a prohibition on me from obtaining, an insurance product or annuity from an unaffiliated entity. By signing, I acknowledge that I have received a copy of this form on today's date. Unless this disclosure is provided electronically or I have applied for credit by mail, I also acknowledge that you have provided this disclosure to me orally....... Consumer Consumer - 2001 Bankers Systems, Inc., St. Cloud, MN Form INS-FED 2/15/2001 (page 1 of 1)
Texas Gulf Bank, N.A. Loan Request Amount Purpose I certify that the information in this application is correct and I am authorizing the lender to check my credit and employment history and to answer questions others may ask about my credit record with the lender. ALL PARTIES SIGNING THIS AUTHORIZATION ARE AFFIRMING THEIR INTENT TO APPLY FOR JOINT CREDIT. A SINGLE SIGNATURE IMPLIES INTENT FOR INDIVIDUAL CREDIT. Applicant Co-Applicant Co-Applicant Texas Gulf Bank, N.A. Solicitude de Prestamo Cantidad Solicitada _ Intento de Prestamo Yo certifico que la informacion en esta aplicacion es correcta y autorizo que el banco investigue mi credito y los antecedentes de mi empleo, y contestar preguntas que otros tengan encuanto a mi credito con mi banco. TODOS LO QUE FIRMEN ESTA AUTORIZACION ESTAN AFIRMANDO SU INTENTO DE APLICAR PARA EL CREDITO EN CONJUNTO. SOLAMENTE UNA FIRMA IMPLICA INTENTO DE CREDITO INDIVIDUAL. Firma de Solicitante Fecha Solicitante en conjunto Fecha Solicitante en conjunto Fecha
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 ofthe following statements as applicable: 0 I AM a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer. "... OR I AM a National Guard member under call of duty authorized by the President or the Secretary of Defense for more than 30 consecutive days OR I AM a commissioned officer of the Public Health Service or the National Oceanic and Atmospheric Administration engaged in 'active service'." 0 I AM a dependent of a member of the Armed Forces on active duty as described above, because I am the member's spouse, the member's child under the age of eighteen years old, I or am an individual for whom the member provided more than one-half of my financial support for 180 days immediately preceding today's date. OR, I AM NOT a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer (or a dependent of such a member). "...AND I AM NOT a National Guard member under call of duty authorized by the President or the Secretary of Defense for more than 30 consecutive days AND I AM NOT a commissioned officer of the Public Health Service or the National Oceanic and Atmospheric Administration engaged in 'active service'." Warning: It is important to fill out this form accurately. Knowingly making a false statement on a credit application is a crime. Borrower(s) Name Borrower Signature Borrower Signature
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT To help the government fight the funding of terrorism and money laundering activities, the U.S. 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, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver s license or other identifying documents.
Rev. 1/15 Why? What? How? Notice of Our Privacy Policy WHAT DOES TEXAS GULF BANK N.A. DO WITH YOUR PERSONAL INFORMATION? Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some, but not all, sharing. Federal law also requires us to tell you how we collect, share, and protect your personal information. Please read this notice carefully to understand what we do. The types of personal information we collect and share depend on the product or service you have with us. This information can include: Social Security number and Income Payment history and Account balances Credit history and Credit Scores When you are no longer our customer, we continue to share your information as described in this notice. All financial companies need to share customers personal information to run their everyday business. In the section below, we list the reasons financial companies can share their customers personal information; the reasons TEXAS GULF BANK N.A. chooses to share; and whether you can limit this sharing. For our everyday business purposes such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus. Yes No For our marketing purposes To offer our products and services to you Yes No For joint marketing with other financial companies Yes No For our affiliates everyday business purposes Information about your transactions and experiences No We don t share For our affiliates everyday business purposes Information about your creditworthiness No We don t share For nonaffiliates to market to you No Call 800-467-7216 or go to www.texasgulfbank.com We don t share
Rev. 1/15 Page 2 Who we are Who is providing this notice? What we do How does TEXAS GULF BANK N.A. protect my personal information? Main Office- TEXAS GULF BANK N.A. 1626 S. Voss Rd. Houston, TX 77057 To protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. How does TEXAS GULF BANK N.A. collect my personal information? Why can t I limit all sharing? Definitions Affiliates We collect your personal information, for example, when you Open an account or Deposit Money Pay your bills or Apply for a loan Show your driver s license We also collect your personal information from others such as credit bureaus, affiliates, or other companies. Federal law gives you the right to limit only Sharing for affiliates everyday business purposes information about your creditworthiness Affiliates from using your information to market to you Sharing for nonaffiliates to market to you State laws and individual companies may give you additional rights to limit sharing. Companies related by common ownership or control. They can be financial and nonfinancial companies. Texas Gulf Bank N.A. does not share with our affiliates. Nonaffiliates Joint Marketing Companies not related by common ownership or control. They can be financial and nonfinancial companies. Texas Gulf Bank N.A. does not share with nonaffiliates so they can market to you. A formal agreement between nonaffiliated financial companies that together market financial products or services to you. Our joint marketing partners include: TIB, The Independent Bankers Bank, a credit card company. Other important information