I certify that all information provided by me herein, including attachments (s) is true, correct and complete.
I authorize Farmers State Bank to make whatever inquiries about me you deem necessary and appropriate for the purpose of evaluating my credit, including obtaining credit reports and contacting my employer.
I also authorize Farmers State Bank to provide credit information about its credit experience with me to other creditors and credit reporting agencies.
I authorize the Bank to obtain address information from the Department of Motor Vehicles and waive the address confidentiality requirements of Section XXXX.XX of the State Vehicle Code.
I agree to provide any further information the Bank might require to process my application.