Message:
Management:
Approval/Decline Reason:
Completed Approval Pre-Requisites:
Describe Reason: Private Notes:
[Update] [Approve] [Reject] [Terminate] [Delete]


ReliaMax Educational Consolidation Loan
Loan Application
Originating Lender: First National Bank in Sioux Falls
Section A: Borrower Data   Please read instructions before completing this section
1. Social Security No.
111111111
2. Last Name
Smith
First Name
John
MI
Jr/Sr
Jr
3. Cosigned?
[] Yes
[X] No
4. Primary Phone
412 788 3900
5. Home Street Address
100 Global View Drive, Suite 800
Apt. #
P.O. Box
City
Warrendale
State
PA
Zip Code
15086
6. Citizenship
[X] US Citizen or National
[] Permanent Resident
7. Date of Birth
03/29/1970
8. Driver's License Number/State of Issuance
9. Secondary Phone
10 Email Address
tsinton@ecsi.net
11. Place of Employment
ECSI
12. Job Title
13. Time with Employer
14. Work Phone Number
Section B: References
15. Reference 1 Last Name
Smith
First Name
John
MI
Jr/Sr
Sr
16. Home Phone
412 788 3901
17. Relationship to Borrower
Father
18. Reference 1 Home Street Address
180 Montour Run Rd
Apt. #
P.O. Box
City
Coraopolis
State
PA
Zip Code
15108
19. Reference 2 Last Name
Smith
First Name
Jane
MI
Jr/Sr
20. Home Phone
412 788 3902
21. Relationship to Borrower
Mother
22. Reference 2 Home Street Address
179 Montour Run Rd
Apt. #
P.O. Box
City
Coraopolis
State
PA
Zip Code
15108
Section C: Financial Data
23. Bank Name (for ACH payments)
24. Account Type
Please Selec
25. Account Number
26. Routing Number
27. Bank Street Address
P.O. Box
City
State
Zip Code
28. Bank Phone Number
Assets Balance Liabilities Balance Monthly Payment
Checking Account $1,500.00 Mortgage Loan $100,000.00 $600.00
Savings Account $15,000.00 Rental/Lease Payments $0.00 $0.00
Primary Residence Value $0.00 Auto Loan 1 $0.00 $0.00
Other Real Estate Value $0.00 Auto Loan 2 $0.00 $0.00
Automobile 1 Value $0.00 Additional Vehicle Loans $0.00 $0.00
Automobile 2 Value $0.00 Credit Card 1 $0.00 $0.00
Additional Vehicle(s) $0.00 Credit Card 2 $0.00 $0.00
Individual Stocks $0.00 Credit Card 3 $0.00 $0.00
Individual Bonds $0.00 Credit Card 4 $0.00 $0.00
Mutual Funds $0.00 Additional Credit Cards $0.00 $0.00
401k/IRA $0.00 Student Loans $0.00 $0.00
Pension $0.00 Personal Loans $0.00 $0.00
Other Assets $0.00 Total Other Debts $0.00 $0.00
TOTAL $16,500.00 TOTAL $100,000.00 $600.00
Income Amount Loans to Consolidate
Annual Salary and Wages $75,000.00 Loan Type Loan Holder Balance
Annual Bonuses & Commissions $0.00 Student Loan Test University $5,000.00
Dividend & Interest Income $0.00 $0.00
Real Estate Income $0.00 $0.00
Investment Income $0.00 $0.00
Retirement Income $0.00 $0.00
Social Security Income $0.00 $0.00
    $0.00
TOTAL $75,000.00 TOTAL   $5,000.00
Section F: Borrower Signature:
55. [X] I/We have read the Promissory Note attached to this application. Promise to pay: Jointly and severally with the other signers below, I/we promise to pay the lender or any other holder of this loan all sums disbursed under the terms of this application, plus interst and all other charges, which may become due as provided for by the Promissory Note. The terms and conditions set forth in this application and the Promissory Note constitute the entire agreement betweeen you and me/us. I/We declare that the information provided above is true and complete to the best of my/our knowledge and belief.

Signature of Borrower
John Smith
Date
11/30/2007
ReliaMax Educational Consolidation Loan Promissory Note (Document ECL2007-A) With First National Bank in Sioux Falls, SD
In this Promissory Note ("Note") the words "I", "me", "my", and "we" mean the below signed borrower and cosigner(s), unless the language specifically refers to only one of the other. "You", "your", and "yours" mean First National Bank in Sioux Falls, 100 S. Phillips Ave., Sioux Falls, SD 57117,and any subsequent holder of this Note.

A. PROMISE TO PAY

I promise to pay to your order according to the terms below the sum of: the Loan Amount Requested, to the extent it is advanced to me, or on my behalf, which includes the Supplemental Fees (together, the "Loan Amount"); other interest, fees and charges accrued or capitalized on the Loan Amount as described in this Note; and, in the event of default, reasonable attorneys� fees, court costs and collection costs to the extent permitted by law.

B. DEFINITIONS

1. 1. Repayment Period - The "Repayment Period" will begin on the date my loan is disbursed and will continue for a period of 36, 48, or 60 months as I indicated on my loan application.
2. Capitalized lnterest and Other Amounts - From time to time, any interest, fees, charges and costs due and not yet paid may be added, without notice, to the principal amount of the loan. This addition is called "capitalizing". Since interest accrues on the outstanding principal balance, capitalizing increases the total cost of the loan.
3. Default - You may declare my loan in default following an event described in Section J except as follows: IDAHO, IOWA, KANSAS, MAINE and SOUTH CAROLINA RESIDENTS ONLY: I will be in default if I fail to make a payment as required by this Note (or within 10 days of the time required by this Note, for Iowa residents) or if the prospect of my payment or performance is significantly impaired. The burden of establishing the prospect of significant impairment is on the lender. WISCONSIN RESIDENTS ONLY: I will be in default (a) if I permit to be outstanding an amount exceeding 1 full payment which has remained unpaid for more than 10 days after its scheduled due date or deferred due date, or I fail to pay the first payment or the last payment within 40 days of its scheduled due date or deferred due date, or (b) if I fail to observe any other provision of the Note, the breach of which materially impairs my ability to pay the amounts due under the Note.
4. Disbursement Date - The date shown on the loan check or the date the loan funds are electronically transferred to my loan holder(s) identified in Section C of the application.
  5. Disclosure - The Truth in Lending Disclosure that will be sent at the time of my first disbursement and which is hereby incorporated into this Note.
6. The terms "Interest", "Late Charge", "Payment Return Fee", "Collection Costs". And "Supplemental Fees" are defined in the Note sections so titled. "Variable Rate" is defined under Section C, Interest, of this Note.
7. "Loan Amount Requested" means the amount of credit requested by the Borrower on the Loan Application.
8. "Loan Application" means the loan application the Borrower submitted to Lender.

C. INTEREST

1. Interest on this Note will accrue at the Variable Rate (as defined below), beginning on the first Disbursement Date, on the principal balance advanced and Capitalized Interest and Other Amounts, until the principal balance and all accrued interest are paid in full.
2. The Variable Rate will change quarterly on the first day of each January, April, July, and October (the "Change Date(s)") if the Current Index changes. The Variable Rate for the Repayment Period is the annual rate equal to the highest U.S. Prime Rate published in The Wall Street Journal (Eastern Edition) "Interest Rates & Bonds" section, "Consumer Rates" table or any successor section or table for the purposes of displaying such rate, the next to the last New York business day before the end of the prior quarter (the "Current Index"), plus a margin of 6.00% (the "Margin"), rounded to the nearest one-eighth of one percent (0.125%). A New York business day is defined as any day that is not a Saturday, Sunday, holiday or other day on which banking institutions in New York are authorized or ordered to close by law or executive order. For example, the Variable Rate for January will be determined by the highest U.S. Prime Rate published in The Wall Street Journal on the preceding December 30th if there is no intervening weekend.
3. If The Wall Street Journal is not published or the U.S. Prime Rate is not stated in the "Consumer Rates" table on the date to be used for the Current Index, then the Current Index will be determined by using the immediately preceding published U.S. Prime Rate. If the Current Index ceases to be available, you will choose a comparable substitute.

D. TERMS OF REPAYMENT

1. Repayment Period - I will make consecutive monthly payments during the Repayment Period in the amounts and on or before the payment due dates shown on my statements until I have paid all of the principal and interest and any other charges I may owe under this Note.
  2. Standard Repayment Terms - You will establish a schedule whereby I will repay my loan in consecutive monthly installments of principal and interest calculated to equal the amount necessary to amortize the unpaid principal and interest at the Variable Rate then in effect over the number of months remaining in the Repayment Period with the payment amount changing in the months of January, April, July, and October.
3. Amounts Owing at the End of the Repayment Period - Since interest accrues daily upon the unpaid principal balance of my loan, if I make payments after my payment due dates, I may owe additional principal and interest, fees and charges at the end of the Repayment Period. In such case, I shall pay the additional amounts, and you may, but are not required to, lengthen the Repayment Period.
4. Minimum Repayment - Notwithstanding paragraphs 2 and 3 of this Section, I agree to pay at least $50 per month, or the unpaid balance, whichever is less, on this Note.
5. Payments - Payments will be applied first to Late Charges, then to Payment Return Fees and Collection Costs, then to accrued interest, and the remainder to principal. Payments in excess of the amount due will advance the next payment due date by the number of whole payments satisfied by the extra funds. (For example, if my payment amount is $100, I am not delinquent and I pay $400 for the month of January, my next payment due date will be May.)
6. If I wish to make a payment in satisfaction of a disputed amount or balance, I must send it to ReliaMax, c/o Heartland ECSI at PO Box 718, Wexford, PA 15086 with a letter of explanation. To the extent permitted by law, you may accept late payments, partial payments, or payments marked "payment in full", or having similar language, without waiving your rights under this Note.

E. LATE CHARGE

I will pay a Late Charge if I fail to make any part of an installment payment within 15 days after it becomes due. The amount of the Late Charge may not exceed $5.00 or 5.0% of the installment, whichever is greater, to the extent permitted by law.

F. SUPPLEMENTAL FEES

1. Insurance Premium - I will pay an amount equivalent to the insurance premium which you pay to ReliaMax Surety Company to for its insurance on this Note. The amount of this insurance premium is ten percent (10.0%) of the loan disbursement amount under this Note.
2. Origination Fee - I will pay an origination fee of $100 to cover the expense of processing my loan application.
3. Added to Disbursement - The amount of the insurance premium and the origination fee will be added to the principal balance of

my loan at the time of disbursement. The total amount lent to me and due under this note will be identified on my disclosure statement. I will not be entitled to any refund of the insurance premium or origination fee once the loan is disbursed.

G. PAYMENT RETURN FEE

If I make a payment and that payment is returned or refused by my bank for any reason, I agree to pay a charge of up to $20.00 for each payment so returned.

H.CHARGES FOR OPTIONAL SERVICES

If I request and you agree to provide optional services to me in connection with my loan, you may charge me and I agree to pay the fees for such services. The fee will be disclosed to me before I accept any such service. Optional services may include, but are not limited to: (1) allowing me to make expedited payment on my loan; and (2) sending documents to me by express delivery or facsimile transmission.

I. RIGHT TO PREPAY

I have the right to prepay all or any part of my loan at any time without penalty.

J. WHOLE LOAN DUE

Subject to applicable law, you have the right to give me notice that the whole outstanding principal balance, accrued interest, and all other amounts payable to you under the terms of this Note are due and payable at once if;
1. I fail to make any payment to you when due; or
2. I fail to provide a notice required in Section M.1 on time; or
3. I break any of my other promises in this Note; or
4. Any bankruptcy proceeding is begun by or against me, or I assign any of my assets to or for the benefit of my creditors, and such proceeding has not been dismissed in 60 days; or
5. I make any false written statement in applying for this loan, or at any time during the Repayment Period; or
6. I die or any cosigner dies; or
7. I am in default on any loans I may already have with you, or on any loans I may have with you in the future. My failure to receive a statement does not relieve me of my obligation to make my required loan payments in accordance with the terms and conditions of this Note. If any of the listed events occur, I will be required to pay interest on this loan accruing afterwards at the Variable Rate applicable to this loan prior to such event.

K. COLLECTION COSTS

If I am in default on this Note, I agree to pay you the reasonable fees and costs (other then attorney�s fees as otherwise provided in this Note) permitted by law that you incur in connection with collecting this Note, including court costs.
 

L. ATTORNEY FEES

If I am in default on this Note, I agree to pay to you the reasonable attorney�s fees permitted by law that you incur in enforcing this Note and any other agreement related to this loan. To the extent permitted by bankruptcy law, I also agree to pay the reasonable attorney�s fees awarded by a bankruptcy or appellate court.

M. NOTICES

1. I will send written notice to you, or any subsequent holder of this Note, within 10 days after any change in my name, address, or telephone number.
2. Any notice required to be given to me by you will be effective when mailed to the latest address you have for me.
3. You may report the status of this loan to any credit bureaus. Late payments, missed payments, or other defaults on your account may be reflected in your credit bureau report.
4. CALIFORNIA RESIDENTS ONLY: A married applicant may apply for a separate account. If you take any adverse action as defined by § 1785.3 of the California Civil Code and the adverse action is based, in whole or in part, on any information contained in a consumer credit report, I have the right to obtain within 60 days a free copy of my consumer credit report from the consumer reporting agency who furnished you my consumer credit report and from any other consumer credit reporting agency which complies and maintains files on consumers on a nationwide basis.
CALIFORNIA and UTAH RESIDENTS: As required by California and Utah law, I am hereby notified that a negative credit report reflecting on my credit record may be submitted to a credit reporting agency if I fail to fulfill the terms of my credit obligations.
IOWA and KANSAS RESIDENTS ONLY: (For purposes of the following notice to Iowa and Kansas residents, "you" means the borrower and cosigner, not the lender.) NOTICE TO CONSUMER 1. Do not sign this paper before you read it. 2. You are entitled to a copy of this paper. 3. You may prepay the unpaid balance at any time without penalty and may be entitled to receive a refund of unearned charges in accordance with law.
MASSACHUSETTS RESIDENTS ONLY: Massachusetts law prohibits discrimination based upon martial status or sexual orientation. MISSOURI RESIDENTS ONLY: ORAL AGREEMENTS OR COMMITMENTS TO LOAN MONEY, EXTEND CREDIT OR FORBEAR FROM ENFORCING REPAYMENT OF DEBT INCLUDING PROMISES TO EXTEND OR RENEW SUCH DEBT ARE NOT ENFORCEABLE. TO PROTECT YOU
  (BORROWER(S)) AND US (CREDITOR) FROM MISUNDERSTANDING OR DISAPPOINTMENT, ANY AGREEMENTS WE REACH COVERING SUCH MATTERS ARE CONTAINED IN THIS WRITING, WHICH IS THE COMPLETE AND EXLUSIVE STATEMENT OF THE AGREEMENT BETWEEN US, EXCEPT AS WE MAY LATER AGREE IN WRITING TO MODIFY IT.
NEVADA RESIDENTS ONLY: This is a loan for study. NEW YORK, RHODE ISLAND and VERMONT RESIDENTS: I understand and agree that you may obtain a consumer credit report in connection with this application and in connection with any updates, renewals or extensions of any credit as a result of this application. If I ask, I will be informed whether or not such a report was obtained and, if so, the name and address of the agency that furnished the report. I also understand and agree that you may obtain a consumer credit report in connection with the review or collection of any loan made to me as a result of this application or for other legitimate purposes related to such loans.
OHIO RESIDENTS ONLY: The Ohio laws against discrimination require that all creditors make credit equally available to all credit-worthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with the law.
VERMONT RESIDENTS ONLY: (For purposes of the following notice to Vermont residents, "you" means any cosigner, not the lender.) NOTICE TO COSIGNER: YOUR SIGNATURE ONTHIS NOTE MEANS THAT YOU ARE EQUALLY LIABLE FOR REPAYMENT OF THIS LOAN. IF THE BORROWER DOES NOT PAY, THE LENDER HAS A LEGAL RIGHT TO COLLECT FROM YOU. WISCONSIN RESIDENTS ONLY: For married Wisconsin residents, my signature confirms that this loan obligation is being incurred in the interest of my marriage or family. No provision of any marital property agreement (pre-marital agreement), unilateral statement under § 766.59 of the Wisconsin Statutes or court decree under § 766.70 adversely affects your interest unless, prior to the time that the loan is approved, you are furnished with a copy of the marital property agreement, statement, or decree or have actual knowledge of the adverse provision. If the loan for which I am applying is granted, I will notify you if I have a spouse who needs to receive notification that credit has been extended to me.

N. ADDITIONAL AGREEMENTS

1. I understand that when you accept the Loan Application, you are not agreeing to lend me money and that there will be no such agreement until the time the first disbursement of the loan is made. You have the right to lend an amount less than the Loan Amount Requested if you certify a lower cost for the loans included in the consolidation. You also have the right to cancel any undisbursed amount if an event occurs as described in Section J of this Note.
2. If this Note is assigned, the assignee will become the owner of this Note and will have all your rights to enforce this Note against me.
3. I understand that you are located in the State of South Dakota and this Note will be entered into in the State of South Dakota. Consequently, the provisions of the Note will be governed by federal laws and the laws of South Dakota to the extent not preempted, without regard to conflict of law rules.
4. Upon receipt of the Disclosure, I will review it and if I am not satisfied with the terms of my loan as approved, I may cancel this Note and all disbursements. To cancel this Note, I will contact you within 3 days of receipt by me of the Disclosure and I will not cash any loan checks. If funds are transmitted electronically, I will authorize return of the funds to you within 3 days of receipt by me of the Disclosure.
5. By accepting past due payments you do not waive or affect any right to accelerate this Note. I waive any notice of dishonor, notice of protest, presentment, demand for payment, and all other notices or demands in connection with this Note and consent to the addition of a party who will be liable upon this loan, to any and all extensions, renewals, or releases of any party liable upon this loan, or waiver or modification that may be granted by you. All without affecting or releasing any borrower or cosigner from such loans. My responsibility for repaying this loan is not affected by the liability of any other person to you or by your failure to notify me that a payment has not been made.
6. If any provision of this Note is held invalid or unenforceable, that provision shall be considered omitted from this Note without affecting the validity or enforceability of the remainder of this Note.
7. This Note may be modified only if you put the modification in writing and the modification is agreed to by any borrower or cosigner. Any such modification does not require the consent of any other borrower or cosigner and will not affect the validity or enforceability of the remainder of this Note.
8. I understand that this loan is an educational loan and is not dischargeable in bankruptcy, except pursuant to 11 U.S. Code § 523(a) 8.
9. I acknowledge that I have received a true and exact copy of this Note.
  10. I may not assign this Note or any of its benefits or obligations. You may assign this Note at any time. The obligations of this Note will be binding on my estate.
11. Your failure to exercise any right hereunder does not constitute a waiver thereof. All waivers must be in writing.
12. I hereby waive all my defenses to the Note based on Suretyship.
13. I understand that you may use automated telephone dialing equipment or an artificial or pre-recorded voice message to contact me in connection with this loan or loan application. You may contact me at any telephone number I provide in this application or I provide in the future, even if that number is a cellular telephone number.

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 me: When I apply for a student loan, you will ask for my name, address, date of birth, and other information that will allow you to identify me. You may also ask to see my driver�s license or other identifying documents. I agree to provide the information you request for these purposes.

O. CERTIFICATION AND CONSENT TO INFORMATION SHARING

1. I certify that the information contained in Sections A, B and C of the application is true, complete and correct to the best of my knowledge and belief and is made in good faith, that I am eligible for this loan and that I will repay it according to the terms of this Note. I understand and agree that my lender will be as listed on the front of the attached application.
I authorize any loan holder that I have identified on my application for loans to be covered by this consolidation loan to release to you, your agents, the guarantor or their agents, any requested information pertinent to the loan (e.g., employment, current address, telephone number). I authorize you, your agents, the guarantor or its agents to check my credit and employment history for this loan and to answer questions about their credit experience with me. I further authorize you to release any other information on this loan to the loan holders whose loans are covered by this consolidation loan and to the guarantor of this loan. I consent to the sharing of any information about this loan with my parent, guardian, child, spouse or sibling who complies with your procedures unless I revoke
  this consent or unless prohibited by law. I understand that I may revoke consent by contacting the servicer at 1-888-549-3274 or ReliaMax c/o Heartland ECSI, 100 Global View Drive, Suite 800, Warrendale, PA 15086.
2. I certify that all of the loan proceeds are solely to pay for qualified higher education expenses.
3. I also certify that: I have read the materials explaining the loan program that have been provided to me; I have read, understand and agree to the provisions of the program, my responsibilities and my rights under this program, the terms of this Note and this "Certification and Consent to Information Sharing".

P. CORRECTION OF ERRORS

All parties to this Note agree to fully cooperate and adjust all typographical, computer, calculation or clerical errors discovered in any or all of the loan documents including the application, Note and Disclosure. In the event this procedure is used, all parties involved will be notified and receive a corrected copy of the changed document.

Q. COSIGNER/STUDENT RELEASE

I agreed that, if any cosigner applicant fails to qualify for this loan, said cosigner applicant will be released from liability hereunder, but this Note will still bind the borrower and any remaining cosigner. As cosigner, I agree that if the borrower is released from liability on this loan for any reason, including infancy, I hereby consent to such release and to my continued liability for this loan after such release.

[X] I certify that I have received a copy of the First National Bank in Sioux Falls Privacy Policy electronically.

[X] By checking this box and submitting this application to First National Bank in Sioux Falls (the "Bank"), I authorize the Bank, and its agents, employees, third party service providers and assignees to (a) obtain a credit report in connection with my application for a loan from the Bank and all amendments, refinancing renewals and modifications of any such loans extended by the Bank and (b) obtain such verification as the Bank deems appropriate from third parties regarding information contained in my application for a loan.




Page: ccgi71 (Ver: 01.01.01 )