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Is this for DBA?
* Indicates Required Field.
Is your mailing address the same as your legal address?
Business Location: *
Type of Ownership: *
Is your mailing address the same as your DBA address?
Type of Ownership:
Has the business declared bankruptcy within the last 10 years? *
Has any principal/owner declared bankruptcy within the last 10 years? *
Any delinquent taxes owed by business or principal/owner? *
Any pending litigation or unsatisfied judgments for business or principal/owner? *
Does any one customer represent more than 10% of annual sales/revenues? *
Is business for sale or under agreement that would change ownership? *
Has business incurred a loss in any of the last two years? *
Approver (Enter & Submit Deposits)
Limited User (Enter deposits only cannot submit deposits)
By checking the box next to each disclosure and clicking the Submit Application button below, I/we consent to receiving the below disclosure related to this application electronically and acknowledge that I/we have read and understand these disclosures.
You may retain a copy of the disclosures by printing them or by saving them to a file on your personal computer. Printed copies of these disclosures may be obtained by calling 844-GREAT-11 or by visiting a branch.
Electronic Disclosure and Consent Agreement
By clicking this check box I/we represents to Greater Hudson Bank that:
(1) I/We are authorized to execute this request on behalf of the business named in this application;
(2) The information provided in this application is true and correct. 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/we 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.
(3) All statements made in this application are made for the purpose of obtaining the Bankâ€™s Remote Deposit Service;
(4) Greater Hudson Bank will retain the original and/or an electronic record of this application, whether or not the application is approved;
(5) Greater Hudson Bank may continuously rely on the information contained in the application, and I/we are 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;
(6) My/Our 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), shall be as effective, enforceable and valid as if a paper version of this application were delivered containing my original written signature.
Acknowledgement. I/We acknowledge that Greater Hudson Bank may verify any information contained in this application or obtain any information or data relating to the Loan, for any legitimate business purpose through any source, including a source named in this application or a consumer reporting agency. Greater Hudson Bank may make inquiries to obtain business reports on the business entity named in this application.*