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* Indicates Required Field.
Is your mailing address the same as your legal address?
Nature of Legal Business: *
Business Location: *
Type of Ownership: *
Is your mailing address the same as your DBA address?
Nature of Legal Business:
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? *
By clicking the Submit Application button below, I/we represents to Greater Hudson Bank that:
I/WE ("APPLICANT") CERTIFY THAT ALL INFORMATION PROVIDED ON AND WITH THIS FORM OR HEREAFTER FURNISHED BY US OR ON OUR BEHALF IS TRUE, CORRECT AND COMPLETE AND THAT I/WE ARE AUTHORIZED TO EXECUTE THIS FORM ON BEHALF OF THE APPLICANT. Applicant(s) are aware that any knowing or willful false statements for purposes of influencing the actions of Greater Hudson Bank ("Bank") can be a violation of federal law 18 U.S.C. sec. 1014 and may result in a fine or imprisonment or both. Bank is authorized to make all inquires you deem necessary to verify the accuracy of this statement either directly or through any agency employed by the Bank for that purpose. Applicant authorizes the Bank to obtain credit reports, and agrees to provide any additional information that the Bank may require to process this application. Applicant also authorizes the Bank to obtain copies of its tax returns and information from the Internal Revenue Service and other taxing authorities, and agrees to execute whatever forms the Bank requests to obtain such information.
I/We acknowledge that you have read and understood this Agreement and the separate agreements, disclosures, schedules and exhibits as they appear on the Bank's website or given to you, including but not limited to, optional services (if selected by you).*