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.
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.
IMPORTANT INFORMATION ABOUT THE PROCEDURES FOR OPENING A NEW ACCCOUNT
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record all information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.
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.