DTI: % LTV: _____ % LOAN FEE: $-==-=-=----=- LOAN #:-:-:::-___ _ VSI : FIRST PAYMENT DUE: SCORE: I

DISBURSEMENT: -=--=-~=:--=-___ _ GRID#: CENSUS: ___ _

NOTING: A&H/CL: ""'TE::":M-:":P:::-:--AUTOPYMT: ___________ _

NAICS:. __________ _ First National Bank MULTI-PURPOSE LOAN APPLICATION

If you intend to apply for joint credit, please initial here. Applicant Co·Applicant

.".111 ~":.I= ~~'1'I~I"":I""1II' ;t·.;1IIt'I~'~.;:i=l' TYPE OF LOAN (Check All That Apply) I AMOUNT REQUESTEO I TERM I RATE REQUESTED I PAVMENT

I NO. OF PAVMENTS

DINDIVIDUAL DJOINT DUNSECURED DSECURED $ PURPOSE OF APPLICATION (Check All That Apply & Describe Request)

DpURCHASE DCONSTRUCTION (PERSONAL HOME) DOVERDRAFT PROTECTION DDESCRIBE:

DHOME IMPROVEMENT DCONSTRUCTION (SPECULATIVE) DHOME EQUITY LINE OF CREDIT

DREFINANCE DCONSTRUCTION I PERMANENT DPERSONAL LINE OF CREDIT

LAST NAME FIRST NAME INITIAL DATE OF BIRTH I # DEPENDENTS MM DD YR

PRESENT ADDRESS DRENT DOWN CITY STATE ZIP CODE HOW LONG HOME PHONE

( )

PREVIOUS ADDRESS (IF PRESENT ADDRESS LESS THAN 2 VRS) CITY STATE ZIP CODE HOW LONG PREVIOUS ADDRESS WAS

DRENTED DOWNED

STATE ISSUE DATE SOCIAL SECURITY NUMBERfTIN I CELL PHONE NUMBER I DRIVER'S LICENSE NUMBER

J MM DD YR MM EXPIRATION DATE I

DD YR

NAME OF NEAREST RELATIVE NOT LIVING WITH VOU I ADDRESS CITY STATE ZIP CODE HOME PHONE

( )

YOUR EMPLOYMENT OR BUSINESS (If self-employed, attach financial statement and tax returns.) NAME AND ADDRESS OF EMPLOVER CITY STATE ZIP CODE BUSINESS PHONE

( )

POSITION I TIME EMPLOVED I GROSS DHOURLV DWEEKLV DMONTHLV DVEARLV SUPERVISOR'S NAME YRS MOS

INCOME: $ (IN TERMS OF MONTHL V: $ )

OTHER INCOME: NOTICE: Alimony, Child Support, Or Separate Maintenance Income Need Not Be Disclosed If Vou Do Not Want It Considered As A Basis For Paying This Obligation.

NAME AND ADDRESS OF PREVIOUS EMPLOVER (IF PRESENT EMPLOVMENT LESS THAN 2 VRS)

I GROSS INCOME I TIME EMPLOVED BUSINESS PHONE

( )

. , , , . ' .. - . - . - , VOUR MARITAL STATUS: DMARRIED DSEPARATED DUNMARRIED (The Term "Unmarried" Includes Single, Widowed Or Divorced)

CO-APPLICANT MARITAL STATUS: DMARRIED DSEPARATED DUNMARRIED (The Term ' Unmarried" Includes Single, Widowed Or Divorced)

. . " , :l"J,,1In • . -- . : LAST NAME FIRST NAME INITIAL DATE OF BIRTH

I # DEPENDENTS

MM DD YR --.,

PRESENT ADDRESS DRENT DOWN CITY STATE ZIP CODE HOW LONG HOME PHONE

( )

PREVIOUS ADDRESS (IF PRESENT ADDRESS LESS THAN 2 VRS) CITY STATE ZIP CODE HOW LONG PREVIOUS ADDRESS WAS

DRENTED DOWNED

SOCIAL SECURITY NUMBERfTIN I CELL PHONE NUMBER I DRIVER'S LICENSE NUMBER

I STATE EXPIRATION DATE

YR I MM ISSUE DATE

MM DD DD YR

NAME AND ADDRESS OF EMPLOVER CITY STATE ZIP CODE BUSINESS PHONE

( )

POSITION I TIME EMPLOVED I GROSS DHOURL V DWEEKLV DMONTHLV DVEARLV SUPERVISOR'S NAME YRS MOS

INCOME: $ (IN TERMS OF MONTHLV: $ ) OTHER INCOME: NOTICE: Alimony, Child Support, Or Separate Maintenance Income Need Not Be Disclosed If Vou Do Not Want It Considered As A Basis For Paying This Obligation.

NAME AND ADDRESS OF PREVIOUS EMPLOVER (IF PRESENT EMPLOVMENT LESS THAN 2 VRS)

I GROSS INCOME TIME EMPLOVED BUSINESS PHONE

( )

QUESTIONS THAT APPLY TO BOTH APPLICANT & CO-APPLICANT Applicant Co-Applicant

ARE THERE ANV OUTSTANDING JUDGMENTS AGAINST VOU? DVES DNO DVES DNO

HAVE VOU BEEN DECLARED BANKRUPT WITHIN THE PAST 7 VEARS? DVES DNO DVES DNO

HAVE VOU HAD PROPERTY FORECLOSED UPON OR GIVEN TtTLE OR DEED IN LIEU THEREOF IN THE LAST 7 VEARS? DVES DNO DVES DNO

ARE VOU OBLIGATED TO PAV ALiMONV, CHILD SUPPORT OR SEPARATE MAINTENANCE? DVES DNO DVES DNO

IF A PURCHASE LOAN, IS ANV OF THE DOWN PAVMENT BORROWED? DVES DNO DVES DNO

ARE VOU A CO-MAKER OR GUARANTOR ON A NOTE? DVES DNO DVES DNO

ARE VOU A SERVICEMEMBER OR A DEPENDENT OF A SERVICEMEMBER? DVES DNO DVES DNO

ARE VOU A UNITED STATES CITIZEN? DVES DNO DVES DNO

tF VOU ARE NOT A UNITED STATES CITIZEN, ARE VOU A RESIDENT ALIEN? (Leave Blank If Not Applicable) DVES DNO DVES DNO , IF VOU ARE NOT A UNITED STATES CITIZEN, ARE VOU A NON-RESIDENT ALIEN? (Leave Blank If Not Applicable) DVES DNO DVES DNO

- . : - --, - - , :It'JI',1In, ADDRESS OF PROPERTY TO BE SECURED I MOBILE HOME? ESTIMATED VALUE? I LAND ONL V? tNIT N0'1 VEAR BUILT I PRIMARV RESIDENCE?

DVES DNO DVES DNO DVES DNO IF A PURCHASE PURCHASE PRICE CASH DOWN CLOSING COSTS PAID BV SELLER LOAN, COMPLETE $ $ $ (ATIACH SALES CONTRACT) THIS ROW: IF A CONSTRUCTION DATE OF LOT PURCHASED ORIGINAL COST I :RESENT VALUE I ~ONSTRUCTION COSTS LOAN, COMPLETE $ (ATIACH PLANS, SPECS, CONTRACT, ETC.) THIS ROW:

- .:, , . -,. - , - , DESCRIBE (Include Any Vear, Make & Model): VEHICLE IDENTIFICATION NUMBER PURCHASE PRICE CASH DOWN

, , NAME OF INSURANCE COMPANV OR AGENT TELEPHONE NUMBER CITY STATE

YOUR ASSETS AND DEBTS I LIABILITIES (INCLUDING CO·APPLICANT)

ASSETS DEBTS I LIABILITIES

DESCRIPTION OWNED BY CASH VALUE CREDITOR IN NAME OF MO. PMT BALANCE ~CANTI~CAHT} (APP. J CQ·APP.) (CHECK BOX IF LOAN

PROCEEDS VVlLl PAY LOAN)

CHECKING/SAVINGS MORTGAGE OR RENT L DCHECKING BANK

MORTGAGE OR RENT -L DCHECKING BANK

DSAVINGS BANK MORTGAGE OR RENT L DSAVINGS BANK

MORTGAGE OR RENT L DBANKlRAs BANK

AUTOMOBILE (DESCRIBE YEAR. MAKE. MODEL) AUTO L AUTOMOBILE (DESCRIBE YEAR, MAKE. MODEL) AUlO L AUTOMOBILE (DESCRIBE YEAR. MAKE. MODEL) AUTO L AUTOMOBILE (DESCRIBE YEAR. MAKE. MODEL) AUTO L LIFE INSURANCE (CASH VALUE) OTHER L Face Amount: $

REAL ESTATE (DESCRIBE TYPE) OTHER L REAL ESTATE (DESCRIBE TYPE) OTHER L SECURITIES (DESCRIBE TYPE) OTHER L

FURNITURE & PERSONAL PROPERTY OTHER L OTHER OTHER L

D 401 K (VESTED) OTHER L D IRAs

D OTHER L D

D TOTAL MONTHLY PAYMENTS: $ >< A TOTAL B TOTAL ASSETS: $ NET WORTH (A minus B): $ DEBTS: $

INFORMATION FOR GOVERNMENT MONITORING PURPOSES Qn!y To Be Completed On Purchases Of Residential Dwellings And Secured By Any Residenlial Dwelling. Home Improvement Of Residential Dwellings (Regardless If Secured Or Not Secured), Or A Refinance Of A Loan In Which Both The Existing Loan And The New Loan Are Secured By Liens On Residential Dwellings. Complete On Construction / Permanent Loans. Do Not Complete On Temporary Loans, Such As Temporary Construction Loans, Nor On Lot Loans.

THE FOLLOWING INFORMATION IS REQUESTED BY THE FEDERAL GOVERNMENT FOR CERTAIN TYPES OF LOANS RELATED TO A DWELLING IN ORDER TO MONITOR THE LENDER'S COMPLIANCE WITH EQUAL CREDIT OPPORTUNITY, FAIR HOUSING, AND HOME MORTGAGE DISCLOSURE LAWS. YOU ARE NOT REQUIRED TO FURNISH THIS INFORMATION, BUT ARE ENCOURAGED TO DO SO. YOU MAY SELECT ONE OR MORE DESIGNATIONS FOR "RACE". THE LAW PROVIDES THAT A LENDER MAY NEITHER DISCRIMINATE ON THE BASIS OF THIS INFORMATION, NOR ON WHETHER YOU CHOOSE TO FURNISH IT. HOWEVER, IF YOU CHOOSE NOT TO FURNISH THE INFORMATION AND YOU HAVE MADE THIS APPLICATION IN PERSON, UNDER FEDERAL REGULATIONS THE LENDER IS REQUIRED TO NOTE ETHNICITY, RACE. AND SEX ON THE BASIS OF VISUAL OBSERVATION OR SURNAME. IF YOU DO NOT WISH TO FURNISH THE INFORMATION, PLEASE CHECK BELOW.

BORROWER: D I Do Not Wish To Furnish This Information CO·BORROWER: D I Do Not Wish To Furnish This Information

ETHNICITY: DHispanic or Latino D Not Hispanic or Latino ETHNICITY: DHispanic or Latino D Not Hispanic or Latino

RACE: DAmerican Indian Dr Alaskan Native DAsian DBlack or African American RACE: DAmerican Indian or Alaskan Native DAsian DBlack or African American

DNative Hawaiian or Other Pacific Islander DWhite DNative Hawaiian or Other Pacific Islander DWhite

SEX: DMaie DFemale SEX: DMaie DFemale

BANK NAME AND NMLS ID*: First National Bank of Manchester 688825 LOAN ORIGINATOR NAME AND NMLS ID*:

identifier number from The Nationwide

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT TO HELP THE GOVERNMENT FIGHT THE FUNDING OF TERRORISM AND MONEY LAUNDERING ACTIVITIES, FEDERAL LAW REQUIRES ALL FINANCIAL INSTITUTIONS TO OBTAIN, VERIFY, AND RECORD 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.

ACKNOWLEDGMENT EVERYTHING THAT I HAVE STATED IN THIS APPLICATION IS CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT YOU WILL RETAIN THIS APPLICATION WHETHER OR NOT IT IS APPROVED. YOU ARE AUTHORIZED TO CHECK MY CREDIT AND EMPLOYMENT HISTORY AND TO ANSWER QUESTIONS ABOUT YOUR CREDIT EXPERIENCE WITH ME.

APPLICANT'S SIGNATURE DATE APPLICANT'S SIGNATURE DATE

FOR BANK USE ONLY

This Application Was Taken: D in a face-to-face inlerview Dbymail Dby telephone Dby Internet

Date Received: Lending Officer:

Form: Loan Application-MultiPurpose (Consumer Purpose & Real Estate Applications)

© 2001 PAT HUBBS CHATIANOOGA, TN 423·8H·0208 2 REV 01·2014

.. First National Bank

INSURANCE INFORMATION & EXTENDING CREDIT

FIRST NATIONAL BANK CANNOT CONDITION AN EXTENSION OF CREDIT ON EITHER YOUR PURCHASE OF AN INSURANCE PRODUCT OR ANNUITY FROM US OR ANY OF OUR AFFILIATES. FIRST NATIONAL BANK ALSO CANNOT CONDITION AN EXTENSION OF CREDIT ON YOUR AGREEMENT NOT TO OBTAIN, OR PROHIBIT YOU FROM OBTAINING, AN INSURANCE PRODUCT OR ANNUITY FROM AN UNAFFILIATED ENTITY

INSURANCE INFORMATION & PURCHASING INSURANCE

Insurance related to the credit extension may be purchased from an insurer or producer of the your choice, subject only to the our right to reject a given insurer or agent as provided in Tennessee Code Annotated 56-B-106(b)(2) . Your choice of insurer or producer will not affect the credit decision or credit terms in any way, except that we may impose reasonable requirements concerning the creditworthiness of the insurer and the scope of coverage chosen as provided in Tennessee Code Annotated 56-B-106(b)(2) . Tennessee Code Annotated 56-B-106(b)(2) states that we cannot "Unreasonably reject a policy furnished by the customer or borrower for the protection of the property securing the credit or lien. A rejection shall not be deemed unreasonable if it is based on reasonable standards, uniformly applied, relating to the extent of coverage required and the financial soundness and the services of an insurer. The standards shall not discriminate against any particular type of insurer, nor shall the standards call for rejection of a policy because it contains coverage in addition to that required in the credit transaction."

ACKNOWLEDGMENT

I have read, understand and acknowledge receipt of the above Insurance Infonnation & Extending Credit and Insurance Infonnation & Purchasing Insurance. I also acknowledge oral receipt of the above Insurance Infonnation & Extending Credit and Insurance Infonnation & Purchasing Insurance unless I have applied for credit by mail or electronically.

APPLICANT'S SIGNATURE APPLICANT'S SIGNATURE

DATE DATE

PLEASE RETAIN FOR YOUR RECORDS

3

First National Bilnk

INSURANCE INFORMATION & EXTENDING CREDIT

FIRST NATIONAL BANK CANNOT CONDITION AN EXTENSION OF CREDIT ON EITHER YOUR PURCHASE OF AN INSURANCE PRODUCT OR ANNUITY FROM US OR ANY OF OUR AFFILIATES. FIRST NATIONAL BANK ALSO CANNOT CONDITION AN EXTENSION OF CREDIT ON YOUR AGREEMENT NOT TO OBTAIN, OR PROHIBIT YOU FROM OBTAINING, AN INSURANCE PRODUCT OR ANNl}ITY FROM AN UNAFFILIATED ENTITY

INSURANCE INFORMATION & PURCHASING INSURANCE

Insurance related to the credit extension may be purchased from an insurer or producer of the your choice, subject only to the our right to reject a given insurer or agent as provided in Tennessee Code Annotated 56-8-1 06(b)(2). Your choice of insurer or producer will not affect the credit decision or credit terms in any way, except that we may impose reasonable requirements concerning the creditworthiness of the insurer and the scope of coverage chosen as provided in Tennessee Code Annotated 56-8-106(b)(2). Tennessee Code Annotated 56-8-106(b)(2) states that we cannot "Unreasonably reject a policy furnished by the customer or borrower for the protection of the property securing the credit or lien. A rejection shall not be deemed unreasonable if it is based on reasonable standards, uniformly applied, relating to the extent of coverage required and the financial soundness and the services of an insurer. The standards shall not discriminate against any particular type of insurer, nor shall the standards call for rejection of a policy because it contains coverage in addition to that required in the credit transaction."

ACKNOWLEDGMENT

I have read, understand and acknowledge receipt of the above Insurance Information & Extending Credit and Insurance Information & Purchasing Insurance. I also acknowledge oral receipt of the above Insurance Information & Extending Credit and Insurance Information & Purchasing Insurance unless I have applied for credit by mail or electronically.

APPLICANT'S SIGNATURE

DATE

APPLICANT'S SIGNATURE

DATE

PLEASE RETAIN FOR YOUR RECORDS

5