MEMBER FDIC

BOC Consumer Loan Application Packet

Applicant ____________________________

Joint Applicant _________________________

Attached as part of this packet are the following disclosures pertaining to your loan for your review and for your records:

Policy for Privacy and Security of Customer Information Disclosure Page

Documents that should be returned to us as part of your application:

Completed Personal Loan Application Form Application Packet Cover Letter (This Page) Most recent W-2 from your employer Documentation for the collateral being offered to secure the loan, i.e. a vehicle title

Marijuana Related Business Certification

Will the proceeds from the loan be used at any time for the purchase of products, sales or cultivation of marijuana/cannaboids, or any of its byproducts including CBD oils, hemp oils, etc.? Including to fund operations for the sales or cultivation of marijuana/cannaboids, including to purchase or rent real estate? ___Yes No Will the source of repayment for the loan come from proceeds for the sale or cultivation of marijuana/cannaboids, or any of its byproducts including CBD oils, hemp oils, etc.? Including funds from operations for the sales or cultivation of marijuana/cannaboids, including to purchase or rent real estate? ___Yes No

By signing below you acknowledge receipt of the above described disclosures and documents at the time of application. You are also authorizing Bank of Commerce to check your credit and employment history and to answer questions about Bank of Commerce’s credit experience with you.

_________________________________________________________________ ___________ We intend to apply for Joint Credit Applicant Date

_________________________________________________________________ ___________ We intend to apply for Joint Credit Joint Applicant Date

Ask your loan officer about our other services:

Consumer Services Platinum Checking with free BOC Checks Senior Platinum Checking with FREE BOC Checks and No Service

Charge if Average Daily Balance is Over $100.00 Free Checking Money Market & NOW Accounts Savings Accounts ATM/Debit Cards Monthly eStatements BOC Connection - Internet Banking with Online Bill

Pay@ www.bankboc.com BOC InfoLine - Telephone Banking @ 918-266-6637 Real Estate Loans Automobile Loans Boat and Recreational Vehicle Loans

Commercial Services

Total Business Checking Free Small Business Checking Non-Profit Checking Business Debit Cards Merchant Credit Card Services Close Personal Banking Monthly Bank eStatements BOC Connection—Internet Banking Business Cash Management with ACH and Wire Features BOC InfoLine—Telephone Banking Commercial Loans Real Estate Loans

Chelsea Sequoyah Adair Catoosa Tulsa Claremore 24 Hour Banking 789-2567 343-2567 785-2446 266-2567 270-2567 342-4913 (918) 266-4747

www.bankboc.com

Disclosure Page Insurance Disclosure – Consumer Credit Application Purchase of Insurance or an Annuity from Bank of Commerce is not required Purchase of Insurance or an Annuity from Others is not prohibited In no way will our decision to extend credit to you be based or conditioned upon whether or not you purchase an insurance product or annuity from us or any affiliate of ours; nor will we prohibit you or ask you not to obtain insurance product or annuity from an unaffiliated entity.

Fair Credit Reporting Act Information Notice Regarding Negative Information We may report information about your account to credit bureaus. Late payments, missed payments, or other defaults on your account may be reflected in your credit report.

Notice Regarding Inaccurate Information We may furnish information about our transactions or experiences with our customers to consumer reporting agencies. If you believe that we have furnished information to a customer reporting agency that is inaccurate, please notify us at the above address and identify the specific information that is inaccurate.

Information Sharing Disclosure and Right to Opt-Out As permitted by the Fair Credit Reporting Act, we may share with our affiliates information solely as to our transactions or experience with you. Fair Credit Reporting Act Notice We may report information about your account to credit bureaus. Late payments, missed payments, or other defaults on your account may be reflected in your credit report.

APPLICATIONPERSONAL LOAN

IMPORTANT: Read these Directions before completing this Application. Check the Appropriate Box.

you are applying for individual credit or an individual account, in your own name, and are relying on your own income or assets and not the income or assets of another person as the basis for repaymentfIof the credit requested, complete only Sections A-D. If the requested credit or account is to be secured, also complete the first part of Section F.

If you are applying for joint credit with another person or for a joint account or an account that you and another person will use, complete all Sections, providing information in Section E about the jointapplicant.

___________________________________________________Co-Applicant_____________________________________________________ApplicantWe intend to apply for joint credit.

If you are applying for individual credit or an individual account, but are relying on income from alimony, child support, or separate maintenance or on the income or assets of another person as the basis foryourepayment of the credit requested, complete all Sections to the extent possible, providing information in Section E about the person on whose alimony, support, or maintenance payments or income or assets

are relying.

APPLICANTSECTION A -

ACCOUNT][SEE REVERSE SIDE FOR IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW

name)(Please print full NAME

ADDRESSPRESENT STREET

ZIPCITY, STATE AND

ADDRESSIMMEDIATE PREVIOUS

STATECITY AND

NUMBERSOCIAL SECURITY

SPOUSELIVING WITH YOU OTHER THAN A PRESENT OR FORMER NOTRELATIVES NAME, ADDRESS AND RELATIONSHIP OF TWO NEAREST

IS:MY PRINCIPAL FINANCIAL INSTITUTION

PHONECELL

ADDRESS:HOW LONG AT THIS

ZIP

REQUESTEDAMOUNT OF LOAN

LOANPURPOSE OF

OWNEDCOLLATERAL OFFERED AND HOW

loan?Have you ever applied to us for a When?If Yes, No Yes

STATEDRIVERS LICENSE NUMBER - DATEBIRTH AGEDEPENDENTS - LIST BY NO. OF

PAYREQUESTED MOS. TO

USEDOTHER FINANCIAL INSTITUTIONS Servicesused:presently

AccountChecking

No.AccountSavings

No.

DepositSafe DepositCert. of

Loan

SECTION B - INCOME AND EMPLOYMENT

CITIZEN?ARE YOU A U.S. No Yes

PHONEHOME

ADDRESS:E-MAIL

ADDRESS:HOW LONG AT THIS

EMPLOYERPRESENT

ADDRESSEMPLOYER

TITLEPOSITION OR

ADDRESSPREVIOUS EMPLOYER AND

TITLEPOSITION OR

to:If you have chosen to disclose income from alimony, child support or separate maintenance, is such income pursuant

WAGESSALARY AND

separateOTHER INCOME- From Whom or Describe (Alimony, child support, or itmaintenance income need not be revealed if you do not wish to have

)considered as a basis for repaying this obligation

IncomeMonthly

PHONEBUSINESS

EMPLOYDATE OF

EMPLOYEDYEARS MONTHLYTOTAL INCOME

ReceivedHow Long OftenHow WhomFrom

ASSETSSECTION C - AgreementWritten DecreeCourt Other

off?Is any income listed in this Section likely to be reduced in the next two years or before the credit requested is paid

_____________________________________________________________________________________________________________________________________(Explain in detail, use separate sheet if needed): Yes No

Year)(Make, Model, AUTOS

(Location)ESTATE REAL

(Name each Company)LIFE INSURANCE

(Describe)ASSETS OTHER

(Name and Address)AUTO INSURANCE AGENTS:

VALUE VALUE VALUE VALUETOTAL

VALUE

VALUECASH

OCCUPIEDDATE

VALUEFACE

VALUE ESTIMATED

TOTALASSETS

INDEBTEDNESSSECTION D - LIABILITIES AND

CARDSCREDIT

rent)(omit HOLDERLANDLORD OR MORTGAGE

etc.List below all indebtedness to banks, credit unions, stores, finance companies, individuals and other creditors, including obligations to pay alimony, child support, separate maintenance, rent, mortgages, ORTYPE OF DEBT

NUMBERACCOUNT ORIGINAL

DEBTPRESENT

OWED AMOUNT COLLATERAL MONTHLY

PAYMENT

PaymentRent Mortgage

NO

CREDITOR

WHEN?YES - you?Have you ever been bankrupt or had any judgments or garnishments against %

rent)(omit

needed.)SECTION E - JOINT APPLICANT, USER OR OTHER PARTY (Use separate sheets, if

TotalsDEBT MONTHLY

% TO INCOME

PAYMENTS MONTHLY

TOASSETS LIABILITIES:

LIABILITIES

incomemust be shown under the "Liabilities and Indebtedness" Section above. (Alimony, child support, or separate maintenance Co-Applicant/Guarantor/Endorser If this Section of Application is completed, the indebtedness of need not be revealed if you do not wish to have it considered as a basis for repaying this obligation)

APPLICANTNAME AND RELATIONSHIP TO

BY EMPLOYED

INCOMEMONTHLY

ADDRESS

LONGHOW TITLEPOSITION OR

INCOMEOTHER

PHONE BUSINESS PHONEHOME NUMBER SOCIAL SECURITY DATEBIRTH

INCOMETOTAL $

checkEverything 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 loan is approved. You are authorized to me.my credit and employment history and to answer questions about your credit experience with

SIGNATURES

(Where Applicable)SIGNATURECO-APPLICANT/CO-SIGNER/GUARANTOR/ENDORSERDATE

DATESIGNATUREAPPLICANTS

X X

CO-APPLICANT

GUARANTOR ENDORSER

Form 642nc(Non-community Property) American Bank Systems, Inc.© Copyright 10/05

off?Is any income listed in this Section likely to be reduced in the next two years or before the credit requested is paid Yes (Explain in detail, use separate sheet if needed): No

SECTION F - MARITAL STATUSUnmarried (including single, divorced, and widowed)SeparatedMarriedOTHER PARTY:Unmarried (including single, divorced, and widowed)SeparatedMarriedAPPLICANT:

STATEDRIVERS LICENSE NUMBER -

(Location)ESTATE REAL OCCUPIEDDATE VALUE

SPOUSELIVING WITH YOU OTHER THAN A PRESENT OR FORMER NOTRELATIVES NAME, ADDRESS AND RELATIONSHIP OF TWO NEAREST

IS:MY PRINCIPAL FINANCIAL INSTITUTION USEDOTHER FINANCIAL INSTITUTIONS Servicesused:presently

AccountChecking

No.AccountSavings

No.

DepositSafe DepositCert. of

Loan

CITIZEN?ARE YOU A U.S. No Yes

CO-SIGNER

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.

When you open an account, we will ask for your name, address, date of birth, and other information that will allow us toWhat this means for you: identify you. We may also ask to see your driver's license or other identifying documents.

Form 642nc(Non-community Property)

American Bank Systems, Inc.© Copyright 10/05