Home Equity Line of Credit or Home Equity Loan Application

Credit Type

Credit Requested

I, (we) intend to apply for joint credit.

Borrower

Co-Borrower

Real Estate

How did you hear about us?

Did you know that HVB offers competitive first mortgage rates and programs?

May one of our Mortgage Finance Consultants contact you regarding our first mortgage programs?

Are either of you a co-maker or endorser on a note?

Are either of you obligated to pay alimony, child support, or separate maintenance?

Marital Status:

Have either of you ever had any suits, judgments, garnishments, bankruptcyor other legal proceedings against you?

Check One:

Any Questions? Please call (267) 280-4040, #206, visit us on-line at www.HUNTINGDONVALLEYBANK.COM or stop by any branch office.

Main Office Justa Farm Office Warrington Office Plumsteadville

2617 Huntingdon Pike
Huntingdon Valley, PA 19006
(215) 947-1300 - Phone
(215) 947-5898- Fax

1990 County Line Road
Huntingdon Valley, PA 19006
(215) 396-0100 Phone
(215) 396-9584 - Fax

610 Easton Road
Warrington, PA 18976
(215) 491-0200 - Phone
(215) 491-4812 - Fax

5725 Easton Road
Plumsteadville, PA 18949
(215) 766-4821 - Phone
(215) 766-9325 - Fax

Authorization Conditions

I/we hereby certify that the above statements are true and correct, and are made for the purposes of obtaining a first or second mortgage equity line of credit or home equity loan from HVB. I/we hereby authorize HVB to verify or reverify any information contained in or related to this application at any time, including but not limited to information from a credit reporting agency. This application shall remain the property of HVB whether the loan is granted or not. I/we fully understand that a Photocopy of a Faxed Copy of this form will serve as authorization.

Acknowledgment and Agreement

Each of the undersigned specifically represents to Lender and to Lender's actual or potential agents, brokers, processors, attorneys, insurers, servicers, successors and assigns and agrees and acknowledges that: (1) the information provided in this application is true and correct as of the date set forth opposite my signature and that any intentional or negligent misrepresentation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Sec. 1001, et seq.; (2) the loan requested pursuant to this application (the "Loan") will be secured by a mortgage or deed of trust on the property described herein; (3) the property will not be used for any illegal or prohibited purpose or use; (4) all statements made in this application are made for the purpose of obtaining a residential mortgage loan ; (5) the property will be occupied as indicated herein; (6) any owner or servicer of the Loan may verify or reverify any information contained in the application from any source named in this application, and Lender, its successors or assigns may retain the original and/or an electronic record of this application, even if the Loan is not approved; (7) the Lender and its agents, brokers, insurers, servicers, successors and assigns may continuously rely on the information contained in the application, and I am obligated to amend and/or supplement the information provided in this application if any of the material facts that I have represented herein should change prior to closing of the Loan; (8) in the event that my payments on the Loan become delinquent, the owner or servicer of the Loan may, in addition to any other rights and remedies that it may have relating to such delinquency, report my name and account information to one or more consumer credit reporting agencies; (9) ownership of the Loan and/or administration of the Loan account may be transferred with such notice as may be required by law; (10) neither Lender nor its agents, brokers, insurers, servicers, successors or assigns has made any representation or warranty, expressed or implied, to me regarding the property or the condition or value of the property; and (11) my transmission of this application as an "electronic record" containing my "electronic signature," as those terms are defined in applicable federal and/or state laws(excluding audio and video recordings), or my facsimile transmission of this application containing a facsimile of my signature, shall be as effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.

Demographic Information Borrower (s)

The purpose of collecting this information is to help ensure that all the applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "Ethnicity" and one or more designations for "Race." The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname. The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below

Borrower

Ethnicity

Race

Sex

Co-Borrower

Ethnicity

Race

Sex