In this Application and Agreement, “you” and “your” mean each person signing this Application and Agreement. “Company” is your business identified in this Application and Agreement. “We”, “us”, and “our” means The Huntington National Bank, with its main office in Columbus, Ohio. “Loan Account” means the business credit line account, business term loan account and/or business time loan account that we open for Company in response to this Application and Agreement.
SECTION I: BUSINESS CREDIT APPLICATION
GENERAL INFORMATION
This Application MUST be completed in full to process the Company’s request. (*Patriot Act Requirements)
“Legal” Name of Company* Tax ID Number*
Company Address* Company Phone Number*
City, State, Zip* Number of Employees
County* Year Established
Annual Sales Revenue Number of Years with Current Owners
Business Checking Bank Account Number Average Checking Balance
Type of Organization:* C Corp. S Corp. Ltd. Partnership Gen. Partnership
Ltd. Liability Co. Non-Profit Sole Proprietor Joint Application
Other
Description of Business (Products and Services) or SIC Code
Has the Company ever declared bankruptcy? No Yes Have any of the guarantors ever declared bankruptcy? No Yes
Are there any outstanding lawsuits? No Yes Are there any outstanding tax obligations? No Yes
Additional Comments:
OWNERS (20% or more)
Please enter Co-Signer, Co-Borrower, and Guarantor information, if applicable.
Name Street Address Social Security # % Ownership Owners Gross Income
Title City, State, Zip Home Phone Number Net Worth
1.
2.
3.
4.
5.
TYPE of CREDIT REQUESTED
Loan Type New/Renewal $ Requested
Business Credit Line
Business Term Loan (monthly installments)
Business Time Loan
Business Overdraft Protection
Checking Account No:
Business Home Equity Line of Credit
ACH Risk Exposure
Total Amount Requested >
PURPOSE
B U S I N E S S
C R E D I T
APPLICATION &
AGREEMENT
COLLATERAL
All Business Assets (includes Accounts, Inventory, and Equipment)
Make Model Value
Equipment/Vehicle
Real Estate (Please Specify):
Address/Location: Estimated Fair Market Value:
Liens/Mortgages: Other (Please Specify):
NOTE: We reserve the right to request the following additional information: (a) Company’s Federal tax returns for the past three years, (b) fiscal year-end statements, with balance sheets and income statements for the past three years, (c) a personal financial statement for each owner or officer listed above, (d) the most recent personal Federal tax return for each owner or guarantor listed.
If your credit references or credit history may be verified under any other name(s), please indicate next to your signature below.
This Application is subject to the approval of, and any credit will be extended by, The Huntington National Bank (“Huntington”), 41 South High Street, Columbus, Ohio 43215.
AUTHORIZATIONS AND REPRESENTATIONS
The signatures below are: (i) the Company’s application through you as its authorized signer(s) for the credit product(s) indicated; (ii) your and the Company’s representation that the questions in the Application have been answered fully and truthfully; and (iii) your and the Company’s understanding that we have no obligation to extend credit unless we approve this Application. Further:
1. You and the Company represent to us that all information provided in this Application or otherwise in connection with the Loan Account is true and correct, is not misleading, and does not contain any material omissions.
2. You authorize us to obtain consumer reports on each of you from consumer reporting agencies in considering this Application, in connection with any extension of credit to the Company and in connection with the review or collection of any of the Loan Accounts. We may obtain business reports on the Company.
3. You and the Company authorize us to release information on this Application and Agreement and the Loan Accounts to consumer and business reporting agencies and others whom we believe have a legitimate need for the information.
4. You and the Company represent to us that each of you is authorized to sign this Application and Agreement on behalf of Company, that each of you have the title with the Company indicated in this Application, and that no other person(s) is required to sign this Application and Agreement in order to bind the Company or to make any of the representations, agreements, or other information in this Application and Agreement accurate, effective and legally binding.
All owners, other principal representatives and all guarantors (collectively, the “signers”) must sign this Application and do so both individually and on behalf of the Company. If there are more than six signers, please copy this Application, complete and sign this section, and attach the copy to this Application.
SIGNER: SIGNER:
Date: Date:
SIGNER: SIGNER:
Date: Date:
SIGNER: SIGNER:
Date: Date:
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 entity or person who opens an account or establishes a
relationship with the institution.
What this means: When an entity or person opens an account or establishes a relationship with us, we may ask for the name,
address, date of birth, and other information that will allow us to identify the entity or person who opens an account or
establishes a relationship with us. We may also ask to see identifying documents for the entity or person.
EQUAL CREDIT OPPORTUNITY ACT NOTICE
INTENT TO APPLY JOINTLY
If there is more than one borrower listed on this application, please check the most appropriate response to the following
question:
[ ] Both applicants have indicated their intention to apply jointly and each has provided his/her own application information.
[ ] The primary applicant affirms that he/she had authority from the joint applicant to apply jointly and to provide application
information on behalf of the joint applicant.
RIGHT TO REQUEST SPECIFIC REASONS FOR CREDIT DENIAL
If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial.
To obtain the statement, please call:
The Huntington National Bank – Business Direct 1-800-480-2001
Or Write To:
The Huntington National Bank
BLC, HM3326
7575 Huntington Park Drive
Columbus, OH 43235-2600
within 60 days from the date of the decision. We will send you a written statement of reasons for the denial within 30 days of
receiving your request for the statement.
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, (provided the applicant has the capacity to enter into a
binding contract); because all or 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:
Office of the Comptroller of the Currency,
Customer Assistance Unit,
1301 McKinney Ave., Suite 3450,
Houston, Texas 77010-9050
OHIO APPLICANTS: THE OHIO 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 OHIO CIVIL RIGHTS COMMISSION
ADMINISTERS COMPLIANCE WITH THIS LAW.
RIGHT TO RECEIVE A COPY OF APPRAISAL
NOTICE: If the collateral that will secure this loan is a 1-4 family residence, you have the right to a copy of the appraisal used
in connection with your application for credit. If you wish to have a copy, please write to us at the following mailing address:
Huntington National Bank
P.O. Box 341470
Attn. NC1W25
Columbus, OH 43234-9909
We must hear from you no later than ninety (90) days after we notify you about the action taken on your credit application, or
no later than ninety days after you withdraw your application. Your written request must contain: Applicant’s Name, Property
Address, Branch Name where application was taken, Application Date, phone number, social security number, and mailing
instructions for the copy. We will process you request promptly, but you should allow 30 days for us to send you your copy of
the appraisal report.
electronic version of 070112152 (4/99)
Huntington
PERSONAL FINANCIAL STATEMENT
Applicant
Spouse
Address
City, State
Zip
Occupation
S.S. #
Date of Birth
Home Telephone
Business Telephone
I am providing this Personal Financial Statement to the Huntington banking or lending office where application is being made (“Huntington”) in connection with: My application to Huntington for an extension of credit or other business relationship.
The application of
to Huntington for an extension of credit or other business relationship, for which I am willing to be a cosigner or guarantor.
The application of
, of which I am a principal owner, partner, executive officer, or director, to Huntington for an extension of credit or other business relationship with Huntington.
Review by Huntington of an extension of credit made by Huntington to me or to another person or entity of which I am a principal owner, partner, executive officer, or director or for which I have cosigned or guaranteed the credit or a review by the Huntington of any other business relationship I or any entity of which I am a principal owner, partner, executive officer, or director have with Huntington.
CONDITION AS OF
(Date)Leave no blanks. Insert “0” or word “NONE” where necessary to complete information
ASSETS $000’s LIABILITIES $000’s
Applicant Spouse Joint Applicant Spouse Joint
Cash on hand and on Deposit (Schedule 1) $ $ $ Notes Payable
U.S. Government Obligations Secured by Real Estate (Schedule 5) $ $ $
Other Investments (Schedule 2) Secured by Other than R.E. (Schedule 6)
IRA and/or Keogh Plans Unsecured (Schedule 6)
Notes Receivable: Contract Accounts Unpaid (Schedule 7)
Secured by Real Estate (Schedule 3) Open Accounts Unpaid (Schedule 7)
Secured by Other Collateral (Schedule 3) Current & Unpaid R.E. Taxes
Unsecured (Schedule 3) Delinquent & Unpaid Interest
Accounts Receivable (Schedule 3) Current Year Federal Taxes
Life Insurance-Cash Value (Schedule 4) Any Other Indebtedness-Itemize
Real Estate-Appraised Value (Schedule 5)
Farm Implements or Machinery
Autos Make Year
Any other Property or Investments-Itemize TOTAL LIABILITIES $ $ $
(Market) NET WORTH $ $ $ TOTAL ASSETS $ $ $ TOTAL LIABILITIES AND NET WORTH $ $ $
Contingent Liabilities
Liability as Guarantor or Cosigner for accounts and Loans of others $
Liability for Leases
Liability other than above-Itemize
TOTAL CONTINGENT LIABILITIES $
ANNUAL INCOME ANNUAL EXPENDITURES
(exc. Ordinary living expenses)
Applicant Spouse Joint Applicant Spouse Joint
Salary, Wages, Commissions $ $ $ Mortgage or Rent $ $ $
Income from Business Income Taxes
Rents and Royalties Insurance Premiums
Income from Investments Property Taxes
Alimony, child support or separate maintenance income need not be revealed if you do
not choose to have it considered as a basis for repaying this loan. Alimony, child support or separate
maintenance.
Other Income-Itemize Other-itemize (include installment payments)
TOTAL INCOME $ $ $ TOTAL EXPENSES $ $ $
electronic version of 070112152 (4/99)
DETAILS RELATIVE TO ASSETS AND LIABILITIES (If space is insufficient, attach supplemental list.)
SCHEDULE 1 – Cash on Deposit
Name of Depository Type Amount Name of Depository Type Amount
$ $
SCHEDULE 2 – Other Investments-Stocks and Bonds
Description Preferred/
Common Number Shares Value Book Market Value Exchange Listed on # Shares Pledged Pledged Where
$ $
SCHEDULE 3 – Notes and Accounts Receivable – Secured and Unsecured
Maker Cosigner or
Guarantor Maturity Rate Paid to Date Interest Amount Face Balance Due List Security
If Secured
% $ $ $
%
%
SCHEDULE 4 – Life Insurance
Issuing Company Beneficiary
Name and Relationship Insurance Kind of Amount Face Cash Value Present Policy Loan Amount of Premium Annual
$ $ $ $
SCHEDULE 5 – Real Estate
Purchase Appraisal
Description & Location Whose Name Title in Amount Date Value Date
Mortgage
Indebtedness Monthly Pmt.
$ $ $ $
By Whom Appraised? When?
SCHEDULE 6 – Notes Payable “Unsecured and with Security other than Real Estate”
Owed To Balance Date When Due Interest Rate Secured, Cosigned or Guaranteed By
$ %
%
%
%
%
SCHEDULE 7 – Contracts and Open Accounts Unpaid
Owed To Amount When Contracted When Due For What
$
OTHER INFORMATION
If no provision has been made for payment of Federal taxes for current year, state estimated amount. $
Are you a partner/owner in any firm? Yes No If so, supply name(s) and interest.
Are there any judgments unsatisfied or suits pending against you and for what amount? Yes No $
Have you ever declared bankruptcy? Yes No If so, when?
Do you have a will? Yes No
Are you obligated on any leases not included in Liabilities above? Yes No
Give details.
Are any of the assets listed on this financial statement controlled by a Trust? Yes No
If so, please note which ones:
Are there any of your assets, other than those indicated in the schedules, pledged or hypothecated in any way? Yes No
Are any liabilities, other than those indicated in the schedules, secured, cosigned or guaranteed? Yes No
I have carefully read the information contained in this Statement and am providing this Statement to Huntington for the purpose of inducing Huntington to
extend or continue credit or other business relationship from time to time in whatever form. I hereby certify that this Statement is a true and correct exhibit of
my financial condition and may be treated by Huntington as a continuing statement thereof until replaced by a new statement or until I specifically notify
Huntington in writing of any changes therein. In consideration of any such credit or other business relationship, I agree if at any time this Statement shall
prove incorrect or misleading, in Huntington’s judgement, as a statement of my then condition, or if at any time by reason of insolvency, application for
receiver, or any act or omission on my part, such credit or other obligation is, in Huntington’s judgement, prejudiced or impaired, all or any of my obligations
to Huntington, whether direct, indirect, contingent or fixed, shall stand immediately due and payable without demand upon or notice to me. I hereby
authorize Huntington to obtain a consumer report or reports to be used in connection with this Statement or the credit or other business relationship to which
it relates and to obtain and exchange credit information from and with other credit grantors and consumer reporting agencies. I authorize Huntington to
retain all information and reports for its files.
If this Statement is given in connection with credit in Ohio, the following disclosure applies:
The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies
maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.
Signature: __________________________________________________________________________________________Date: _ ___________
