KOA Application

Required Field

Business Information

Business Type

Indicate by your initials if it is your intent to apply jointly

Campground Information

Is the address the same as the business address?

Credit Request

Credit Type

Please select which financing plan you would prefer

*Note: Fixed payments can be monthly payments or fixed payments during the camping season.

*Note: "Term" refers to the length of the loan in numbers.

Management/Ownership Information

Owner

Add Another Reference

Have you ever filed bankruptcy in the last 10 years?

Endorsement

I/We hereby agree to allow Kampgrounds of America, Inc. (KOA, Inc.) to release information to Independence Bank, Havre, Montana and Celania, LLC. Such information may include but not be limited to registration and camper night franchise reports, previous royalty payment history, current merchandise credit limit and balance owing, number of years as a KOA franchisee, campground inspection reports and/or any other reports deemed necessary. I/we further authorize Independence Bank to order a credit report and verify other credit information, including past credit references, both personal and corporate. I/We further authorize Independence Bank to share any personal and entity financial information along with credit information it collects and uses with Celania, LLC and KOA, Inc. to approve and maintain this loan. In conjunction with this loan transaction I intend to sign the note on behalf of the business and guarantee the loan.

Greetings!

Thank you for choosing INDEPENDENCE BANK to provide your campground needs!

The partnership between KOA franchisees and Independence Bank began in 2002. Since that time, the partnership has grown to include KOA customers in over 40 states and Canada. We offer programs designed exclusively for KOA Campground owners ----Go With the Flow Financing and KOA Real Estate Term Financing for a purchase or refinance. We look forward to working with you and your campground.

NOTICE: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); 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 this creditor is: FDIC CONSUMER RESPONSE CENTER, 1100 Walnut St., Box #11, Kansas City, MO 64106

NOTICE: If your application for a loan is denied, you have the right to receive a written statement of specific reason for the denial. If upon denial you are not initially provided with such a statement, to obtain one please contact us at the address or telephone number provided in this application, within 60 days from the date you are notified of our decision. I/We will send you a written statement of reason for the denial within 30 days of receiving your request for that statement.

Please retain these disclosures for your records.

Please feel free to call or contact the INDEPENDENCE BANK KOA Department at l-800-823-2274 or 1-406-265- 1241 or Box 2090, Havre, MT 59501.

Your KOA campground experts,

Deborah Callahan
Senior Vice President of Lending
Branch President KOA Campground Lending

Carol Murch
KOA Loan Assistant

Nate Molstad
KOA Lending Officer

Janett Pugh
KOA Loan Assistant

Mike Atkinson
Campground Specialist/KOA Lending Officer

Lisa Jackson
Credit Analyst

Chuck Celania
KOA Consultant