By my/our signature on this application, either as a principal of the applicant or a personal guarantor of applicant’s obligations, I/we hereby declare under the penalty of perjury that all information contained in this application and all financial information I/we provide is true, correct and complete as of the date it is being submitted to Heritage Hills Financial or its designee. I/we understand that Creditor is relying upon this document and upon the information contained in it for the purpose of extending, modifying or renewing credit. I agree to inform Creditor immediately of any change or deterioration in the information or values stated herein. I/we authorize Heritage Hills Financial or its designee (and any assignee or potential assignee thereof), to verify any of the information from whatever source it deems appropriate, which authorization shall extend to obtaining and review of my/our personal credit profile from any national credit bureau in considering this application and subsequently for the purpose of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. If this application for business credit is denied, you have the right to a written statement with the specific reasons for denial. To obtain the statement contact Heritage Hills Financial within 30 days of the date that you are notified of said denial. Heritage Hills Financial will email you a written statement of the reasons for denial within 30 days of receiving such a request. I/we understand and agree that the submitting of this application does not constitute an approval, or guarantee of any loan, line of credit or other funding. I/we understand and agree to indemnify Heritage Hills Financial should any direct or indirect damages result from either the submission of this application or from the receipt of any credit lines, loans, or other business or personal funding from any direct lenders that this application is shared with. I/we understand and agree that the jurisdiction of this application is the state of Florida, and that any litigation would be conducted under such. Notice: The Federal Equal Opportunity Act prohibits creditors from discriminating against applicants on the basis of race, color, religion, national origin, sex, marital status, or age (providing the applicant has the capacity to enter into a binding contract); or 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 the creditor is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580. A copy or facsimile of this application with signature shall be considered to be an original.