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Insurance disclosure for credit application


  Lender: QNB
15 N. Third Street
P.O. Box 9005
Quakertown, PA 18951-9005

IMPORTANT

DO NOT CHECK TO ACCEPT THIS FORM UNTIL YOU CAREFULLY
READ IT AND UNDERSTAND ITS CONTENT
 

Purpose.

You have submitted an application for a loan. In connection with your loan application, Lender may be soliciting, offering to sell, or will sell you an insurance product or annuity. Federal law requires Lender to provide you with the following disclosures.

Credit Disclosures.

1.   Lender, as a condition of granting you a loan, cannot require that you purchase an insurance product or annuity from Lender or any of its affiliates.

2.   Lender, as a condition of granting you a loan, cannot require your agreement not to obtain or prohibit you from obtaining an insurance product or annuity from an unaffiliated entity.

Acknowledgment.

BY CHECKING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THIS INSURANCE DISCLOSURE.
THE DISCLOSURES WILL BE MAILED WITHIN 3 BUSINESS DAYS.

APPLICANT:

  I accept

  Print and keep in your records