PATRIOT ACT INFORMATION DISCLOSURE


PATRIOT ACT INFORMATION DISCLOSURE

APPLICANT NAME:

CO-APPLICANT NAME:

PRESENT ADDRESS:  

MAILING ADDRESS:  

 

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

I/we acknowledge that I/we received a copy of this disclosure.

 

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Premium Lending LLC https://premiumlendingllc.com
Signature Certificate
Document name: PATRIOT ACT INFORMATION DISCLOSURE
Unique Document ID: 0878539def77f464e8037478e09b45345d186f7a
Timestamp Audit
June 25, 2019 6:40 am MSTPATRIOT ACT INFORMATION DISCLOSURE Uploaded by Jacob Greenberg - Jakegreenberg22@premiumlendingllc.com IP 144.178.64.58