Finance Umbrella Application

FINANCE UMBRELLA APPLICATION

Use this application to request an umbrella credit facility or aggregate credit accommodation covering multiple underlying credit lines. Completion and submission of this application does not constitute an approval or offer of credit. The Applicant certifies that the information provided is true and correct and authorizes verification as set forth in the Certifications section.

1. Applicant Information

Corporation LLC Partnership Sole Proprietor Other

2. Authorized Contact

3. Business Operations

4. Requested Umbrella Facility

Revolving Credit Term Loan Overdraft / Line Guarantee / Bond Facility

Requested Effective Date:     Anticipated Drawdown Date:

5. Financial Summary (Most Recent Fiscal Year)

Fiscal Year Ending:

Audited Financial Statements Interim Financial Statements Tax Returns Bank Statements

6. Existing Credit Facilities

Provide details for up to three material existing facilities. If additional space is required, attach a separate schedule.

7. Security and Collateral

None Accounts Receivable Inventory Real Estate Equipment Guarantor Other

8. Declarations, Covenants and Compliance

The Applicant represents and warrants that all information provided in this application and in any accompanying schedules or exhibits is true, complete and correct in all material respects. The Applicant has the corporate or organizational power and authority to enter into this application and to perform the obligations herein. The Applicant further covenants to notify the Lender promptly of any material adverse change in financial condition or business operations.

Compliance and Sanctions: The Applicant certifies that neither it nor any principal is subject to economic sanctions or prohibited transactions under applicable laws, and that it will comply with all applicable anti-money laundering and sanctions requirements in connection with the facility.

Authorization to Verify: The Applicant authorizes the Lender and its agents to obtain credit reports and to verify, directly or indirectly, any information provided in this application including contacting trade references, financial institutions and other third parties. The Applicant agrees to provide additional documentation upon request and to indemnify the Lender for reasonable costs of verification, except where prohibited by law.

By checking the boxes below, the Applicant acknowledges and agrees to the statements and consents indicated.

Applicant consents to credit and background checks

Applicant agrees to be bound by lender's standard facility documentation if and when an offer is extended and accepted

No material adverse change has occurred since the date of the most recent financial statements provided

9. Additional Information

10. Certifications and Signature

Certification: The undersigned certifies that they are authorized to execute this application on behalf of the Applicant and that the information contained herein and in any attachments is true and complete to the best of their knowledge. The Applicant understands that any intentional misstatement or omission of material facts may constitute an event of default under any facility subsequently granted and may be grounds for criminal prosecution under applicable law.

Acknowledgement: The Applicant acknowledges that submission of this application may require the Lender to expend time and resources in reviewing the request. The Applicant agrees that the Lender may, in its sole discretion, decline the request without liability and that no credit commitment exists until definitive facility documents are executed by all required parties.

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