Digital Signature
For the purpose of establishing and maintaining credit, the undersigned submits the foregoing statement and information contained on this sheet, both written and printed, and including supplemental sheets, if any, as being a full, true and correct statement of my financial condition and all above matters, on the date stated. The undersigned agrees to notify you immediately in writing of any materially unfavorable change in my financial condition of the above matters, and in the absence of such notice or of a new and full written statement, all matters herein may be considered as a continuing statement and substantially correct. The undersigned hereby authorizes MHC Financial Services, Inc., its assignees and/or designees to make inquiry into, to request, and to receive any information concerning my character, general reputation, personal characteristics, mode of living, and all information from creditors which MHC Financial Services, Inc., its assignees and/or designees deems relevant for the granting and collection of the proposed borrowing. This authorization shall be effective from the date upon which this application is signed and is extinguished automatically upon full payment of the present borrowing, if any is granted. Upon my written request, additional information as to the scope of this inquiry, if one is made, will be provided.
I understand that the decision to grant or deny credit will be at the sole discretion of MHC Financial Services, Inc. as determined by the credit department located at 11120 Tomahawk Creek Parkway, Suite 100-A, Leawood, Kansas 66211.
I further represent that neither the undersigned, any principal officer of the undersigned, nor any contemplated operator of any equipment proposed to be purchased has any record or reputation of having violated any federal or state laws relating to liquor, narcotics or contraband; and no such person has been convicted of a felony.
By checking this box, and pressing submit, I certify my intent to electronically sign this Application. This electronic signature ensures that I am the Applicant as provided and identified in the Application, indicates my approval of the information, terms and conditions contained in the Application, affirms the accuracy of the information provided in the Application and serves as my intent to sign. I acknowledge, accept and understand that my electronic signature is admissible in court and constitutes a written and electronic signature in accordance with The Federal Global and National Commerce Act and The Uniform Electronic Transactions Act as in effect in any relevant jurisdiction, including, without limitation, the state of Kansas. Further, by checking this box and pressing submit, I acknowledge that I have read and understand the terms and conditions of this Application in their entirety.
