Vehicle	Signature	Home Equity

By submitting this application, you: 1. Certify that the information submitted is current, correct and complete. 2. Agree that this application is our property and need not be returned to you. 3. Authorize us to verify the accuracy and completeness of all information from any source we choose including credit reporting agencies. 4. Authorize us to provide credit information about our credit experience with you to other creditors and credit reporting agencies. 5. Agree we may obtain from the applicable motor vehicle licensing agency in your state information about your current address, even though this information might be available to us without this authorization.

CUSTOMER NOTICE: To help the government fight the funding of terrorism and money laundering activities, U.S. Federal law requires financial institutions to obtain, verify, and record information that identifies each person (individuals and businesses) who opens an account. What this 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.

NEW YORK RESIDENTS: A consumer report may be requested in connection with this application and the applicant may, upon request, be informed whether or not a consumer report was requested, and if a report was requested, informed of the name and address of the consumer reporting agency that furnished the report.

OHIO RESIDENTS: 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.