Commercial Loan Application Form

Commercial Loan Application

USA PATRIOT ACT NOTICE: IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW 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 (for this law a loan is considered an account). What that 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. Additional identifying information or documents will be requested from entities (such as a corporation, partnership, trust, or other entity).

Section I - Applicant Information

Business Legal Name (Borrower) *

Business Phone # *

Co-Borrower Name (if applicable)

Email *

State Domiciled *

Tax Identification # *

Business Start Year *

Physical Address (Street / City / State / Zip) *

Mailing Address (Street / City / State / Zip)

Website

Legal Structure *

Tax Structure *

Describe the core business operation, products and/or services *

Please answer the following:

Is the business currently involved in any litigation or claims? * Yes No

Are any applicant(s) or proposed guarantor(s) tax obligations, including payroll and/or sales tax, past due? * Yes No

Does the business now or in the future participate in any internet gambling? * Yes No

Is the business in any way related to the cannabis/marijuana industry? * Yes No

Does the business operate a money services business, ATMs or transact any virtual currency? * Yes No

Has the applicant(s) or any proposed guarantor(s) ever declared bankruptcy or had any judgment, repossessions, garnishments or other legal proceeding(s) filed against them in the last seven (7) years? * Yes No

Section II - Request and Collateral

Loan Request

Amount Requested *

Loan Type Requested *

Request Purpose *

Collateral Offered

Add

Section III - Owners

List all owners with 20% or more ownership of the business

Add

Section IV - Requested Attachments

Borrower & Co-Borrower Financial Information:

Most recent 2-years filed Federal tax returns w/ all schedules and K1s for all Borrowing entities listed

Most recent 2-years filed Federal tax returns w/ all schedules and K1s for each owner listed above

As an authorized representative of the Applicant, each individual certifies that all the information provided herein and in any supporting documentation with this application is true and correct. The undersigned acknowledge(s) and agree(s) that First Security Bank, its agents, successors and assigns, may check credit, conduct a background investigation on the business and/or its owners and contact trade references in reviewing this application. The undersigned further acknowledge(s) and agree(s) the First Security Bank may also inquire as to and obtain credit reports on the herein-named Applicant(s), Owner(s) and Guarantor(s). All principals with 20% or more ownership must sign the credit application below. All requests are subject to underwriting and credit approval. To help the government fight the funding of terrorism and money laundering activities, Federal law requires all banks to obtain, verify and record information that identifies each person who opens an account.

Appraisal Notice and Application Signature(s)

Owner 1: *

Date: *

Appraisal Disclosure:

If you are pledging residential real estate as collateral for your loan request, we may order an appraisal to determine the property's value and charge you for this appraisal. We will promptly give you a copy of any appraisal, even if your loan does not close. You can pay for an additional appraisal for your own use at your own cost. For all other loan types, you have the right to receive a copy of the appraisal report used in connection with your application for credit. If you wish to have a copy, please write to us at the following mailing address. In your request, please include the applicant names(s), the application date and property address in connection with your loan request. First Security Bank 316 Byron Ave N. Byron, MN 55920 By executing this loan application, individually or as a group, whether through written, digital or electronic means, the applicant(s) acknowledge that they have received a copy of this Disclosure of Right to Receive a Copy of an Appraisal.

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