ࡱ > bjbj(( 4 JcJc B B f f f ! N f ^ f f f ; f f e'5 | " 0 ! ! ! ` f f f f f f f t f f f f f f f ! f f f f f f f f f B O : CREDIT REPORT AUTHORIZATION AND PRIVACY DISCLOSURE FORM I hereby authorize and instruct Nationwide Business Lenders, LLC to obtain and review my credit report. My credit report will be obtained from a credit reporting agency chosen by NBL or the lender. I understand and agree that Integrity NBL and the lender(s) intend to use the credit report fo the purpose of evaluating my financial readiness to obtain a commercial loan. In addition, in connection with determining my ability to obtain a commercial loan, I authorize Nationwide Business Lenders, LLC to share with other potential lenders my credit report and any information that I have provided, including any computations and assessments that have been produced based upon such information. PATRIOT ACT DISCLOSURE 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 you: As part of applying for your commercial loan, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We will also need a copy of the driver's license or other identifying documents from any and all borrowers and guarantors. We will need a separate authorization from each business and each guarantor. _____________________________________ __________________________________ Guarantor Name Company Name _____________________________________ __________________________________ Signature Authorized Business Owner __________________________ Date Version Date 11-1-16 < = E T p } , - ? ^ _ a $ 1 @ F R Y Z [ !hy 5B*CJ \^J aJ ph+++ !h#ga 5B*CJ \^J aJ ph+++ j h: UmH nH u h hw hly hK h & h#ga h" h#ga 5CJ aJ h#ga 5CJ aJ hCU j h Uh#ga 3 < = v & ' t $ 7$ 8$ H$ ^a$gd