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This application submitted electronically shall have the same force and effect as if the application bore an inked
original signature(s). The above information, together with any accompanying financial statements, schedules, or other
materials, is submitted for the purpose of obtaining credit and is warranted to be true, correct and complete. The
undersigned hereby warrants that any individual identified above who is either a principal, a personal guarantor or a
sole proprietor of the credit applicant, recognizing that his or her individual credit history may be a factor in the
evaluation of the credit history of the applicant, has provided his/her written authorization for inquiry into their
credit worthiness, including but not limited to obtaining a consumer credit report, and shall hold
Providence Capital and its assignees, agents or nominees
harmless from same. You understand that such investigation
may include seeking information as to the background, credit
and financial responsibility of your officers and principals
(or any of them). The Federal Equal Credit Opportunity Act
prohibits creditors from discriminating against credit
applicants on the basis of race, color, religion, national
origin, sex, marital status or age (provided the applicant
has the capacity to enter into the binding contract);
because all or part of the applicant's income derives from
any public assistance program; or because the applicant has
in good faith exercised any right under the Consumer Credit
Protection Act. If for any reason your application for
business credit is denied, you have the right to a written
statement of the specific reasons for the denial.
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