Schedule 1: Checking and Savings Accounts


Schedule 2: Securities/stocks/bonds/mutual funds/stock


Schedule 3: IRA's, 401(k), Retirement Accounts


Schedule 4: Life Insurance


Schedule 5 & 7: Real Estate


Schedule 6: Accounts Payable & Installment Loans


The information contained in this statement for the purpose of obtaining, or maintaining credit with you on behalf of the undersigned, or persons, firms or corporations in whose behalf may either severally or jointly with other execute a guaranty in your favor. Each undersigned understands that your are relying on the information provided herein (including the designation made as to ownership of property) in deciding to grant or continue credit. Each undersigned represents and warrants that the information provided is true and complete and that you may consider this statement as continuing to be true and correct until a written notice of change is given to you by the undersigned. You are authorized to make all inquiries you deem necessary to verify the accuracy of the statements made herein, and to determine my/our creditworthiness, including obtaining personal credit bureau reports. You are authorized to answer questions about your credit experience with me/us.

Notice: The State Laws against discrimination require that all creditors make credit equally available to all credit-worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The State Civil Rights Commission administers compliance with this law.

By submitting this application, I/we authorize a consumer credit report and verify the statements in this application. Furthermore, I/we agree to be bound by the terms and conditions of the debit card, and the electronic funds transfer disclosure, copies of which will be mailed to the applicant if a card is granted. Receipt of terms and conditions, and disclosure, and acceptance of such terms will be conclusively presumed by use of the card. If this is a joint application, the undersigned shall be jointly and severally liable for any and all debit card transactions. Both parties must sign if a joint account is desired.