Personal Banking

Insurance Disclosure For Credit Application

IMPORTANT: DO NOT AGREE TO THIS FORM UNTIL YOU HAVE CAREFULLY READ IT AND UNDERSTAND ITS CONTENT.

Purpose

You’re submitting an application for a loan. In connection with your loan application, Lender may be soliciting, offering to sell, or will sell you an insurance product or annuity. Federal law requires Lender to provide you with the following disclosures.

Credit Disclosures

1. Lender, as a condition of granting you a loan, cannot require that you purchase an insurance product or annuity from Lender or any of its affiliates.

2. Lender, as a condition of granting you a loan, cannot require your agreement not to obtain or prohibit you from obtaining an insurance product or annuity from an unaffiliated entity.

Acknowledgment

By agreeing below, I acknowledge that I have read, received and understand this insurance disclosure.

BY AGREEING BELOW, I ACKNOWLEDGE ON BEHALF OF THE LENDER THAT AN ORAL DISCLOSURE OF INSURANCE WAS DULY MADE TO THE APPLICANT AND THAT APPLICANT ACKNOWLEDGED RECEIPT OF THE DISCLOSURE.

I agree. I’d like to sign up!

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