BUSINESS LOAN APPLICATION ( NON-REAL ESTATE )

Similar documents
Small Business Loan Checklist (Loan Exposure up to $500,000 (1) )

PROFESSIONAL PRACTICE GROUP APPLICATION

Member Business Credit Application

Commercial Loan Application

BUSINESS LOAN APPLICATION COMPANY INFORMATION

BUSINESS LOAN APPLICATION

AMOUNT REQUESTED PAYMENT DATE DESIRED PROCEEDS OF CREDIT TO BE USED FOR $

Business Loan Application

Attorney Credit Application Package

Business Loan Application Packet

DATE APPLICANT/GUARANTOR SIGNATURE APPLICANT/GUARANTOR (PLEASE PRINT) APPLICANT/GUARANTOR (PLEASE PRINT) APPLICANT/GUARANTOR SIGNATURE DATE

DATE APPLICANT/GUARANTOR SIGNATURE APPLICANT/GUARANTOR (PLEASE PRINT) APPLICANT/GUARANTOR (PLEASE PRINT) APPLICANT/GUARANTOR SIGNATURE DATE

IMPORTANT INFORMATION ABOUT OPENING A LEGAL ENTITY ACCOUNT

BUSINESS LOAN APPLICATION COMPANY INFORMATION

Business Convenience Credit Application

We Want To Be Your Bank!

Provide Details of Your Credit Relationships Name of Creditor Type of Loan Original Amount Balance Owing Monthly payment Note Date Maturity Date

All-In-One Business Loan Application

USA PATRIOT ACT INFORMATION DISCLOSURE Important Information about Application Procedures

Black Hills Community Economic Development 504 Loan Application

PERSONAL FINANCIAL STATEMENT for National Equity Funding. Federal law requires all financial institutions obtain,

Business Loan Application

MEMBER BUSINESS LOAN APPLICATION INSTRUCTIONS

Thank you for considering Union Bank for your commercial financing.

BUSINESS LOAN APPLICATION COMPANY INFORMATION

CONVENTIONAL / SBA LOAN APPLICATION BUSINESS LOAN APPLICATION CHECKLIST

l SECURED other sources FOR HOW LONG PAYMENT DATE DESIRED WANT TO REPAY l MONTHLY l SECTION A - INDIVIDUAL APPLICANT INFORMATION

Application for Commercial Real Estate Loan

ITEMS NEEDED TO PROCESS YOUR CONSUMER/AUTO LOAN APPLICATION

BUSINESS LOAN APPLICATION

efipco GENERAL CREDIT APPLICATION (For Wisconsin residents only) Date of Application

Fall River Office of Economic Development Small Business Administration (SBA) Microloan Program

1. LOAN APPLICANT. Loan Applicant General Information. Legal Name Organizational Form, Where and When Organized (ex., Corporation, Delaware, 1984)

Applications will only be accepted from

RADA COMMUNITY INVESTMENT CORPORATION LOAN APPLICATION FORM

Business Loan Application Package

SMALL BUSINESS LOAN APPLICATION (for Commercial loans $100,000 or less)

APPLICATION CHECKLIST. LICENSE Clear copy of a driver s license for each borrower if you are not already a customer of The First Bank of Greenwich

Loan Application Checklist. Entity Specific Documentation. All Entities. Valid Government Photo ID for all borrowers, applicants, and guarantors

P E R S O N A L F I N A N C I A L S T A T E M E N T

KERR-TAR REGIONAL COUNCIL OF GOVERNEMNTS APPLICATION FOR BUSINESS LOAN

SBA 504 Loan Application EQUAL OPPORTUNITY LENDER

00 Apply Online. This application overview will help you understand what information we will collect in order to process your application.

Commercial Laundry Credit Application

Borrower Signature Authorization

PERSONAL FINANCIAL STATEMENT AS OF

FINANCIAL STATEMENT. Creditor's Name and Address. ASSETS Note: Complete SCHEDULES first. LIABILITIES

CREDIT APPLICATION. Year Business Started: Annual Revenues in Most Recent Year Average Split % # of Employees

FINANCIAL STATEMENT PERSONAL INFORMATION. Name. Home Address. Social Security # Home Phone. Employer. Employer Address. Title.

PHOLICIOUS INC CREDIT DEPARTMENT

Stockbridge-Munsee Community Band of Mohican Indians. Mohican Loan Department Business Loan Application

Real Estate Loan Application

NORTH DELTA PLANNING AND DEVELOPMENT DISTRICT, INC. MINORITY BUSINESS ENTERPRISE LOAN PROGRAM

Instructions for Completing the Uniform Residential Loan Application Fannie Mae 1003 / Freddie Mac 65

Surety Bond Application Checklist

Microloan Checklist Supporting documents to provide with loan application

HOME EQUITY APPLICATION CHECKLIST

2 of 10 CommercialLoanApplication0715

Legal BusinessName. Business Start Date Number of Locations. Entity Type EIN # Business Address. Mailing Address. Bus. Ph.

BUSINESS VISA CARD APPLICATION

Purpose (use of funds) Collateral: Unsecured Real Estate Vehicle Accounts Receivable Inventory Equipment Deposits/Securities Other (Describe)

9404 Genesee Avenue, Ste#100, La Jolla, CA P F Member FDIC Equal Housing Lender

All-In-One Business Loan Application

PERSONAL FINANCIAL STATEMENT

CDP/SPAT Collaborative Shellfish Business Loan Program

COMMERCIAL LOAN APPLICATION

Glenville Local Development Corporation

HOME MODEL YEAR HOME MANUFACTURER HOME LENGTH HOME WIDTH LOT RENT STREET ADDRESS OF MANUFACTURED HOME CITY STATE ZIP CODE

Spearfish Economic Development Corporation Community Capital Revolving Loan Fund. Application Information

Kemba Commercial Loan Application

BUSINESS LOAN APPLICATION

Dear prospective and existing restaurateurs and proprietors of York City fresh food establishments:

PERSONAL FINANCIAL STATEMENT 7(a) / 504 LOANS AND SURETY BONDS

APPLICATION FOR SMALL BUSINESS LOAN

NORTH DELTA PLANNING AND DEVELOPMENT DISTRICT, INC. MINORITY BUSINESS ENTERPRISE MICRO LOAN PROGRAM

PLEASE. To Process your Application we must have the following:

SHORT FORM CREDIT APPLICATION (For Wisconsin residents only)

CONVENTIONAL LOAN APPROVAL APPLICATION

C.O.D. Enhancement Programs Enrollment and Authorization Form

MEMBERSHIP ACCOUNT CARD Membership #

LEGACY BANK BUSINESS CREDIT APPLICATION

SIMPLE IRA CUSTODIAL ACCOUNT ADOPTION AGREEMENT

NEW ACCOUNT APPLICATION Do not use this form for IRA accounts.

BUSINESS LOAN APPLICATION. Note: We encourage you to speak with a loan officer before submitting a loan application.

WAREHOUSE LINE APPLICATION 1 COMPANY INFORMATION (MAIN OFFICE OR PARENT COMPANY) 2 CORPORATE FILING INFORMATION

Freehold Savings Bank, 68 West Main Street, Freehold, N.J Commercial Mortgage Construction Loan Term Loan Equipment Loan Line of Credit

FINANCING APPLICATION Revised 8/16

INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT ADOPTION AGREEMENT

INDIVIDUAL RETIREMENT CUSTODIAL ACCOUNT ADOPTION AGREEMENT

Loan Application Checklist

Collateral. Equity. Credit history

Small Business Loan Application

1. Type of Application. Joint Credit - By initialing below, you intend to apply for joint credit. 2. Type of Requested Credit. Repayment Interval $

BORROWER DISCLOSURES and PRIVACY POLICY

PERSONAL INFORMATION

Business Account Application

FINANCIAL STATEMENT - INDIVIDUAL

APPLICATION A N D A G R E E M E N T FOR REFUND TRANSFER AND REFUND DEPOSIT ACCOUNT

Small Business Lending Documents User Guide

PERSONAL FINANCIAL STATEMENT. In Dollars (Omit cents)

Transcription:

BUSINESS LOAN APPLICATION ( NONREAL ESTATE ) Thank you for allowing Equitable Bank the opportunity to assist you with your business needs. To help expidite your loan application, please submit a complete application package to us so that we may review your request. Should you need assistance, please contact your loan officer or contact our Commercial Loan Department at (781) 3378000. APPLICATION FORMS: (provided by Equitable Bank) Commercial Loan Application Form Patriot Act (Important Information About Procedures for Opening a New Deposit or Loan Account) Personal Financial Statement Attached: Privacy tice ORGANIZATIONAL DOCUMENTS: Corporation: Articles of Incorporation; Bylaws/Charter; Federal Tax ID Number Limited Liability Company (LLC): Certificate of Organization; Operating Agreement; Federal Tax ID Number Partnership: Partnership Agreement; Certificate or Election filed w/ the Secretary of State; Federal Tax ID Number Sole Proprietor: Business Certificate; Federal Tax ID Number if separate from Proprietors Social Security Number FINANCIAL INFORMATION: (from borrowing entity and all guarantors) Federal Tax Returns (signed and dated) organization and personal 3 years Current Personal Financial Statement (on the Bank s form provided) Corporate financial statements FYE and Current (Profit & Loss, Balance Sheet) 3 years For new business or expansions: 3 Year Profit & Loss Projection Seller's Financials, if purchase Proforma balance sheet Opening balance sheet COLLATERAL INFORMATION: OTHER: Unsecured Motor Vehicle: Purchase Agreement/Invoice, Make/Model, VIN # Equipment: Purchase Agreement/Invoice, Make/Model and Serial Numbers Business Assets: Description of Assets, Purchase Agreement, if applicable G:\private\Lending\Commercial Lending\Application; Cover Page & Docs (attach App & PFS) n Real Estate.doc REVISED 05/2017

BUSINESS LOAN APPLICATION DATE: For Bank Use Date Rec'd: New Relationship Branch: Officer: Existing Relationship Application Number: Action taken: Approved Declined Withdrawn IMPORTANT APPLICANT INFORMATION: Federal law requires financial institutions to obtain information to verify your identity. You may be asked several questions 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. BUSINESS INFORMATION Business Name: Business Address*: Tax ID Number: Telephone: Year Established: Organized Under the Laws of: Business Activity: NAICS Code: # of Employees: Annual Gross Revenues: $ Entity Type: (must provide organizational documentation) Corporation LLC Proprietorship SCorporation Partnership nprofit (US State) Date of Last Annual Report Filing with the Commonwealth of Massachusetts: Minorityowned Womanowned Franchise If a franchise, provide franchise agreement * Years at Present Location Own Lease If leased, provide copy of lease agreement Key Contact: Relationship: Cell Phone: Email: OWNERSHIP DISTRIBUTION Attach Separate Sheet If Necessary Name: Title: Ownership %: Residence: Cell Phone: Birthdate: SSN: Email: Name: Title: Ownership %: Residence: Cell Phone: Email: Birthdate: Name: Title: Ownership %: Residence: Cell Phone: Email: Birthdate: It is the Bank s policy that all persons and entities having an ownership interest of 20% or more in the Borrowing entity must guarantee the loan. SSN: SSN: 1 of 5

LOAN REQUEST Amount of Loan Requested: $ Type of Loan: Line of Credit Requested Term of Loan: months Term Loan Time te (< 1 year) Specific Loan Purpose: (Check all that apply) Working Capital Finance Purchase of Inventory (attach list of inventory to be purchased along with quotes or invoices) Finance Purchase of Equipment (attach equipment info, listing, and/or bill of sale) Finance Purchase of Vehicle (attach listing, purchase agreement/ bill of sale and copy of title, if available) Finance Purchase of Existing Business (attached purchase agreement and seller's financial information) Refinance of Existing Loan Debts (attached recent statements for all debts to be consolidated) Other: Collateral Available: (Check all that apply) All Assets (including, but not limited to: accounts receivable, inventory, machinery and equipment) Specific Equipment: Year/make/model: Serial #: Specific Vehicle: Year/make/model: VIN: Cash Held on Deposit with Equitable Bank: EB Account number: Personal Assets (as described in Personal Financial Statement) Real Estate, solely as an abundance of caution: Other: For Purchases: Purchase Price: $ Down Payment: $ ( %) TradeIn $ ( %) Comments on Loan Request: FINANCIAL INFORMATION Primary Business Banking Relationship: Customer Since: Today's Date: Average Deposit Balance: $ Credit Relationships: Attach schedule of business debt. (form provided) Total Commercial Lines: Total Commercial Loans: $ $ Balance $ $ Monthly Payment Total Cash in Bus. Account: $ Total Business Assets: $ Business Net Sales: $ Total Business Liabilities $ Business Net Profit: $ Total Business Net Worth: $ 2 of 5

MISCELLANEOUS INFORMATION Has the company operated at a loss during the past 3 years? Are tax liabilities current? If no, the current outstanding tax obligation is: $ Is the business an endorser, guarantor, or comaker for any obligations not listed in the financial statements? If yes, what is the contingent liability: Has the business or a principal owner ever declared bankruptcy? Has or is the business a defendant in any lawsuit? If yes, provide details on a separate sheet. (list of outstanding judgements, threatened lawsuits, arbitration, or other proceedings against the Applicant/Business) Are any of the business assets encumbered by liens or attachments? If yes, please provide further information: What: By Whom Amount: $ What: By Whom Amount: $ What: By Whom Amount: $ JAMES GRAZIANO, EVP AND SENIOR LOAN OFFICER EQUITABLE BANK 744 BROAD STREET EAST WEYMOUTH, MA 02189 within 60 days from the date you are notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving your request for this statement. The notice that follows describes additional protections extended to you. FEDERAL CONSUMER HELP P.O. BOX 1200 MINNEAPOLIS, MN 55480 CREDIT DENIAL NOTICE If your gross revenues were $1,000,000 or less in your previous fiscal year, and if your application for business credit is denied, you have the right to obtain a written statement of the specific reasons for the denial. To obtain the statement please contact: EQUAL OPPORTUNITY NOTICE The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (providing the applicant has the capacity to enter into a binding contract), because all or a part of the applicant s income derives from any public assistance program, or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal Agency that administers compliance with this law concerning this creditor is: 3 of 5

JOINT CREDIT NOTICE If this application is for Joint Credit, Borrower & CoBorrower each agree that we intend to apply for Joint Credit. We intend to apply for joint credit. (Initials) (Initials) (Initials) (Initials) SIGNATURES By signing below, Loan Applicant submits this application and the information provided on all accompanying financial statements and schedules for the purpose of obtaining credit and represents that the information submitted is accurate and complete. Loan Applicant acknowledges that representations made in this application will be relied on by the Lender in evaluation this application and, if approved, in extending credit. Loan Applicant 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 to in writing. Lender is authorized to conduct any inquires it decides are necessary to verify the accuracy of the information contained in this application and to use any reasonable method to determine the creditworthiness of the Loan Applicant. Lender is also authorized to answer any questions from others about the Lender s credit experience with the parties in this application. Loan Applicant will promptly notify Lender of any subsequent changes with would affect the accuracy of this application, and will provide all documents and information that the Lender decides are necessary to complete this application. Loan Applicant authorizes Lender to retain this application, whether or not Lender approves any extension of credit. Any intentional misrepresentation of the information contained herein could result in criminal action under federal law. 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 consumer credit report on them. APPLICANTS NAME: (Print) BY: X Title: Date: BY: X Title: Date: BY: X Title: Date: COAPPLICANTS NAME: (Print) BY: X Title: Date: BY: X Title: Date: BY: X Title: Date: Guarantor(s) Signature: Guarantor(s) Signature: Guarantor(s) Signature: Guarantor(s) Signature: X X X X Date: Date: Date: Date: 4 of 5

BUSINESS LOAN APPLICATION CHECKLIST Equitable Bank Business Loan Application Organizational Documents (Articles of Incorporation, Partnership Agreement, Bylaws, etc.) Schedule of Existing Business Debt (form provided) Business Tax Returns for the past three (3) years Business Financial Statements for most recent year end (Profit & Loss Statement, Balance Sheet) Business Interim Financial Statements (if available) Accounts Receivable Aging Report as of last month end (if applicable) Accounts Payable Aging Report as of last month end (if applicable) Personal Financial Statement(s) for each Principal/Guarantor Personal Tax Returns for the past three (3) years for each Principal/Guarantor Patriot Act Form (form provided) OTHER: OTHER: OTHER: If Applicant is a new business or if the loan is for expansion, please submit: A detailed 3year Profit & Loss Projection (Proforma) A written business plan Resumes of all owners 5 of 5

BUSINESS DEBT SCHEDULE Include the following information on all installment debts, notes, contracts, and mortgages. Current balance must match the current balance sheet. Include all capital leases shown on the balance sheet (if any). Do not include accounts receivable and accounts payable. Business Name As of Name of Creditor Original Amount Original Date Current Balance Interest Rate Maturity Date Monthly Payment Collateral Current or Delinquent Total Current Balance Total Monthly Payment Signature: Title: Date:

SCHEDULE 2 Marketable Securities. Show all marketable securities you own, including Stocks/Bonds registered and traded on national exchanges or over the counter, Treasury Bills, Municipal Bonds, Commercial Paper, and Margin Loans with brokerage firms. If completing by hand and there is not enough space, attach a separate schedule. INSTRUCTIONS FOR YOUR PERSONAL FINANCIAL STATEMENT At EQUITABLE BANK, we want to help you make the most of your opportunities. The more information we have about your financial background, the better we can evaluate your financial needs. All statements will be held confidential. If you are applying for credit with another person, or if you are relying on another person's income or assets to obtain credit, please fill out all information for both the applicant and coapplicant. Information about your spouse need not be included unless this is a joint statement with your spouse or if you are relying on his or her income or assets to obtain credit. The Bank is not required to consider jointly held assets in evaluating an individual credit request. All parties whose assets are relied upon will be requested to sign notes or other documents required in connection with credit extended. Please read everything carefully. As you complete each schedule, you will notice that the totals appear in a boldly outlined block. These blocks will provide the information you need for the financial summary on the last page of this form. If there is nothing to report, indicate "none" on the schedule and "0" on the financial summary. If you have any questions, please call us. SCHEDULE 1 SCHEDULE 10 Cash Accounts. Please include all account relationships you have Limited Partnership Investments. with a bank/money market fund, such as checking and savings accounts, bank loans, Certificates of Deposit, money market funds, etc. However, do not include mortgages or consumer loans. SCHEDULE 11 Privately Owned Businesses or Professional Practices. Please indicate what percentage is owned by you, and the estimated current market value of the business. SCHEDULE 12 Other Major Assets / Personal Effects. Please list any items not already included, such as airplanes, boats, seats on exchanges, automobiles, jewelry, furs, antiques, oriental rugs, objects of art, paintings, stamp and coin collections. SCHEDULE 3 nmarketable Securities. Please include nonmarketable securities and investments (those not publicly traded), as well as restricted stock. If any of the securities are pledged, please explain. You do not need to include privately owned businesses or professional practices, as there is a separate schedule for this. SCHEDULE 4 Consumer Loans. Please indicate all installment loans, including auto loans, credit cards, charge accounts, etc. SCHEDULE 5 Real Estate for Personal Use. Please include first and second mortgages, including home equity lines of credit. SCHEDULE 6 Real Estate for Investment. Please include the same information as above, but for investment property, including second mortgages and revolving lines of credit secured by real estate. SCHEDULE 7 Accounts / tes Receivable. SCHEDULE 13 Deferred Assets. These should include trusts, vested pensions, deferred income, stock options, hypothecated securities, 401K plans, IRAs, and profit sharing plans. SCHEDULE 14 Contingent Liabilities. Please list any contingent liabilities on leases, legal claims, contracts, standby letters of credit, and as comaker, surety, endorser, or guarantor for debts of others. SCHEDULE 15 Annual Income. You do not need to include alimony, child support, or separate maintenance income unless you would like it to be considered in evaluating creditworthiness. SCHEDULE 16 Annual Expenses. Please provide a fair estimate of all your major expenses. SCHEDULE 17 Assets and Liabilities. If completing by hand, please insert the Totals from each of the Schedule #s throughout this form. Please make sure the figures are correct, and sign at the bottom. SCHEDULE 8 Other Major Liabilities. Accounts, tes, Taxes Payable. Please include repayment terms and collateral. SCHEDULE 9 Life Insurance: This should include cash surrender value and any amount you may have borrowed against your life insurance. 1

PERSONAL FINANCIAL STATEMENT Personal Financial Statement as of Individual Statement Joint Statement Applicant PERSONAL INFORMATION CoApplicant First Name M.I. Last Name First Name M.I. Last Name Street Address Home Telephone Street Address Home Telephone City State Zip Code City State Zip Code Tax ID/SSN Date of Birth Tax ID/SSN Date of Birth Business Name Position Business Name Position Business Address Business Telephone Business Address Business Telephone City State Zip Code City State Zip Code Name of Account Manager and present bank Name, Address of your accountant Name, Address of your attorney Name, Address of person having a durable power of attorney Name of Account Manager and present bank Name, Address of your accountant Name, Address of your attorney Name, Address of person having a durable power of attorney PLEASE ANSWER THE FOLLOWING QUESTIONS 1. Are you a defendant in any suit or legal action? (explain below) Applicant CoApplicant 2. Are you presently subject to any unsatisfied judgements or tax liens? (explain below) 3. Have you or an entity of which you were partial owner ever been through bankruptcy or settled any debts for less than full amount? (explain below) 4. Are any of your income tax returns currently being audited? (explain below) If yes, what years? COMMENTS BELOW FOR ANY OF THE ABOVE QUESTIONS: 2

PERSONAL FINANCIAL STATEMENT SCHEDULE 1 CASH ACCOUNTS Name of Bank / Deposit Account / Money Market Fund Deposit Balance Funds Pledged Account Number Ownership (Applicant, Co Applicant or Third Party) TOTAL SCHEDULE 2 MARKETABLE SECURITIES Firm/Institution Holding Securities Name of Stocks, Bonds, # Shares, etc. Cost Market Value Are Securities Pledged? To whom? Brokerage Margin Loans Ownership TOTAL SCHEDULE 3 NONMARKETABLE SECURITIES Description of Security Date Acquired Cost Book Value Estimated Market Value Ownership TOTAL SCHEDULE 4 CONSUMER LOANS (For additional space use insert sheet) Total Amount Auto Loans, Credit Cards, Credit Unions, Charge Accts, Etc. Total Monthly Payments Outstanding Ownership TOTAL 3

PERSONAL FINANCIAL STATEMENT SCHEDULE 5 REAL ESTATE FOR PERSONAL USE Property Address and Description Legal Owner Purchase Year Purchase Price Market Value Present Loan Balance Lender TOTAL Property Address and Description SCHEDULE 6 REAL ESTATE FOR INVESTMENT Purchase Legal Owner Purchase Price % Ownership Market Value Year Present Loan Balance Lender GROSS TOTALS % SHARE OWNED Date of Accounts / tes Receivable SCHEDULE 7 ACCOUNTS / NOTES RECEIVABLE Due From Original Amount Present Balance Repayment Terms TOTAL SCHEDULE 8 OTHER MAJOR LIABILITIES (ACCOUNTS / NOTES / TAXES PAYABLE) Date of Obligation Due To Original Amount Present Balance Repayment Terms / Collateral TOTAL 4

PERSONAL FINANCIAL STATEMENT Insurance Company Face Amount of Policy SCHEDULE 9 LIFE INSURANCE Type of Policy Beneficiary Cash Surrender Value Amount Borrowed Ownership TOTAL SCHEDULE 10 LIMITED PARTNERSHIP INVESTMENTS Share of Investments Date Acquired Cash Invested Estimated Market Value Share of Debt or LP Liability Number of Shares / % Owned TOTAL Business Name and Address SCHEDULE 11 PRIVATELY OWNED BUSINESSES OR PROFESSIONAL PRACTICES Type of Business Date of Investment Original Investment Cost % Ownership Gross Market Value of Business Ownership GROSS TOTALS % SHARE OWNED SCHEDULE 12 OTHER MAJOR ASSETS / PERSONAL EFFECTS Item Cost Estimated Present Value Ownership TOTAL SCHEDULE 13 DEFERRED ASSETS (IRAs, PENSIONS, STOCK OPTIONS; See instructions) Description Amount Ownership TOTAL SCHEDULE 14 CONTINGENT LIABILITIES (GUARANTOR FOR LOAN, ETC.; See instructions) Description Amount Ownership TOTAL 5

PERSONAL FINANCIAL STATEMENT SCHEDULE 15 ANNUAL INCOME Last Year's Actual Income Applicant CoApplicant Combined Salary and/or Net Professional Income Bonus and Commissions Interest and Dividends Net Real Estate Income Capital Gains (Losses) Other Income (Describe below) TOTAL This Year's Estimated Income Applicant CoApplicant Combined Salary and/or Net Professional Income Bonus and Commissions Interest and Dividends Net Real Estate Income Capital Gains (Losses) Other Income (Describe below) TOTAL SCHEDULE 16 ANNUAL EXPENSES Estimate of Current/Actual Expenses Applicant CoApplicant Combined Income Tax Condo Payments Mortgage Payments (personal residence) Real Estate Taxes (personal residence) Rent Payments Insurance Premiums (RE, Auto, etc.) Tuition Alimony, Child Support Other Payments for Debt Owed Other Expenses (utilities/food/clothing, etc.) TOTAL FAMILY INFORMATION Name Relation Date of Birth Dependent? COMMENTS / REMARKS: 6

PERSONAL FINANCIAL STATEMENT SCHEDULE 17 SUMMARY OF ASSETS AND LIABILITIES ASSETS LIABILITIES CASH ACCOUNTS BANK ACCT FUNDS PLEDGED from Schedule 1 from Schedule 1 MARKETABLE SECURITIES MARGIN LOANS from Schedule 2 from Schedule 2 NONMARKETABLE SECURITIES CONSUMER LOANS from Schedule 3 from Schedule 4 REAL ESTATE FOR PERSONAL USE MORTGAGESPERSONAL REAL ESTATE from Schedule 5 from Schedule 5 REAL ESTATE FOR INVESTMENT MORTGAGES ON INVESTMENT REAL from Schedule 6 ESTATE: from Schedule 6 ACCOUNTS / NOTES RECEIVABLE OTHER MAJOR LIABILITIES from Schedule 7 from Schedule 8 CASH VALUE OF LIFE INSURANCE LOANS AGAINST LIFE INSURANCE from Schedule 9 from Schedule 9 LTD PARTNERSHIP INVESTMENTS LTD PARTNERSHIP INVESTMENT from Schedule 10 LIABILITY from Schedule 10 PRIVATELY OWNED BUSINESSES TOTAL LIABILITIES from Schedule 11 (Sum of all values listed above) OTHER MAJOR ASSETS NET WORTH from Schedule 12 (Total Assets minus Total Liabilities) TOTAL ASSETS TOTAL LIABILITIES PLUS NET WORTH (Sum of all values listed above) DEFERRED ASSETS CONTINGENT LIABILITIES from Schedule 13 from Schedule 14 INCOME LAST YEAR CURRENT INCOME from Schedule 15 from Schedule 15 ANNUAL EXPENSES from Schedule 16 The information contained in this statement is provided to induce EQUITABLE BANK (the Bank ) to extend or to continue the extension of credit to the undersigned or to others upon the guaranty of the undersigned. The undersigned acknowledges and understands that the Bank is relying on the information provided herein in deciding to grant or continue credit or to accept a guaranty thereof. The undersigned understands that Bank s credit approval is subject to verification and investigation. Each of the undersigned represents, warrants, and certifies that (1) the information provided herein is true, correct and complete and gives a correct and complete showing of the financial condition of the undersigned, (2) the undersigned has no liabilities direct, indirect or contingent except as set forth in this statement, and (3) legal and equitable title to all assets listed herein is in the undersigned s sole name, except as may be herein otherwise noted. Each of the undersigned agrees to notify the Bank immediately and in writing of any change in name, address, or employment and of any material adverse change (1) in any of the information contained in this statement or (2) in the financial condition of any of the undersigned or (3) in the ability of any of the undersigned to perform its (or their) obligations to the Bank. In the absence of such notice or a new and full written statement, this should be considered as a continuing statement and substantially correct. If credit is granted, the undersigned agrees to provide an updated statement on at least an annual basis. The undersigned hereby authorizes the Bank to make all inquiries it deems necessary to verify the accuracy of the information contained herein, and to determine the creditworthiness of the undersigned, and the undersigned hereby authorizes all persons of whom the Bank makes such inquiries to respond thereto in full. Each of the undersigned authorizes the Bank to answer questions about your credit experience with the undersigned. Applicant Signature Date CoApplicant Signature Date 7

REAL ESTATE OWNED DETAIL (SCHEDULE 5 and 6 OF PERSONAL FINANCIAL STATEMENT) *** Please List All Personal Residence(s) & Investment Real Estate *** BORROWER/OWNER: PRIMARY RESIDENCE: PROPERTY ADDRESS NUMBER OF RESIDENTIAL UNITS NUMBER OF COMMERCIAL UNITS PROPERTY OWNER(S) 1 ST MTG BALANCE 1 ST MTG PAYMENT MONTHLY P&I AND TAX ESCROW 2 ND MTG BALANCE 2 ND MTG PAYMENT MONTHLY P&I CURRENT ESTIMATE OF VALUE DATE/YEAR OF PURCHASE & PURCHASE PRICE MORTGAGE OWED TO P&I $ TAX ESCROW $ P&I $ TAX ESCROW $ P&I $ TAX ESCROW $ P&I $ TAX ESCROW $ P&I $ TAX ESCROW $ P&I $ TAX ESCROW $ P&I $ TAX ESCROW $ THE ABOVE REPRESENTS THE COMPLETE REAL ESTATE HOLDINGS OF THE UNDERSIGNED. BORROWER S SIGNATURE: DATE:

PATRIOT ACT INFORMATION FORM IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW DEPOSIT OR LOAN ACCOUNT To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an Account. What this means for your is that 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. All new account applicants must complete this form. PRIMARY APPLICANT Name: Address: City, State, Zip: Social Security Number: Date of Birth: Home Phone: Work Phone: JOINT APPLICANT Name: Address: City, State, Zip: Social Security Number: Date of Birth: Home Phone: Work Phone: DESCRIPTION OF GOVERNMENT ISSUED IDENTIFICATION All applicants will need to have a Government Issued Identification that includes a picture along with a second proof of identification to be reviewed by a Bank employee and/or the Bank s closing attorney. GOVERNMENT ISSUED IDENTIFICATION (Describe identification issuing authority; for example: Massachusetts Driver s license or Massachusetts issued identification, passport and Country of issue). Government Issued Identification: Identification number: Place of issuance: Date of issuance: Identification expiration date: SECOND ID PRESENTED Government Issued Identification: Identification expiration date: Identification number: Place of issuance: Date of issuance: Type Expiration Date Type Expiration Date Last 4 digits of Identification #: Last 4 digits of Identification #: Viewed by: Viewed by: Name Date Name Date

Unlawful Internet Gambling Enforcement Act (UIGEA) The Unlawful Internet Gambling Enforcement Act ( UIGEA or the Act ) prohibits anyone in the business of betting or wagering (as defined by the Act) from knowingly accepting payments in connection with unlawful Internet gambling, including payments made through credit cards, electronic funds transfers, and checks. Unlawful Internet gambling means placing, receiving, or otherwise knowingly transmitting a bet or wager by any means which involves the use, at least in part, of Internet gambling where such bet or wager is unlawful under any applicable federal or state law in the state or tribal lands in which the bet or wager is initiated, received, or otherwise made. A restricted transaction is any transaction in which a person accepts credit, funds, instruments or other proceeds from another person in connection with unlawful Internet gambling. Designated payment systems covered by the Act are (i) automated clearing house (ACH) systems, (ii) card systems, (iii) check collection systems, (iv) money transmitting businesses, and (v) wire transfer systems. The Department of Treasury and the Federal Reserve Board have issued a joint final rule, Regulation GG, to implement the Act. Regulation GG requires certain participants in payment systems that could be used for unlawful Internet gambling to have policies and procedures reasonably designed to identify and block or otherwise prevent or prohibit the processing of restricted transactions. Banks are required to comply with the Act beginning June 1, 2010. The Department of Treasury and the Federal Reserve Board require all banks to notify our business customers of this regulation. In accordance with the requirements of the Unlawful Internet Gambling Enforcement Act of 2006 and Regulation GG, we are required to inform you that restricted transactions as described above are prohibited from being processed through any Equitable Bank account or relationship. The interagency guidance published on May 20, 2010 can also be viewed at www.federalreserve.gov/boarddocs/srletters/2010/sr1011.pdf

rev. August 2015 FACTS WHAT DOES EQUITABLE BANK DO WITH YOUR PERSONAL INFORMATION? WHY? WHAT? HOW? 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 transaction or loss history Payment history and transaction history Credit history and account transactions 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 Equitable Bank chooses to share; and whether you can limit the sharing. Reasons we share your personal information Does Equitable Bank Share? Can you 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 For our marketing purposes To offer our products and services to you For joint marketing with other financial We don t share companies For our affiliates everyday business purposes Information about your transactions and experiences For our affiliates everyday business purposes We don t share Information about your creditworthiness For our affiliates to market to you We don t share For nonaffiliates to market to you We don t share Questions? Call toll free 8005144311 or go to weymouthbank.com

Page 2 Who we are Who is providing this notice? Equitable Bank What we do How does Equitable Bank protect my personal information? How does Equitable Bank collect my personal information? Why can t I limit all sharing? 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. We collect your personal information, for example, when you Give us your contact information or open an account. Apply for a loan or provide employment information 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 purposesinformation about your creditworthiness Affiliates from using your information to market to you Sharing for nonaffiliates to market to you Definitions Affiliates naffiliates Joint Marketing 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. Our affiliates include Equitable Bancorp. Inc. and Equitable Bank. Companies not related by common ownership or control. They can be financial and nonfinancial companies. Equitable Bank 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. Equitable Bank doesn t jointly market.