If you are retired, self-employed, a homemaker, or student, please complete Employment Information section to the best of your ability.
List all debts to banks, loan or finance companies, charge accounts, and installment purchases. Include debts on which applicant is a co-maker, endorser, or guarantor.
If you or a joint applicant or other party answers "yes" to any of the following questions, please explain in the space provided.
CUSTOMER CONSENT & ACKNOWLEDGEMENT
ELECTRONIC SIGNATURES IN GLOBAL AND NATIONAL COMMERCE ACT
a/k/a e-Sign Act
Informed Consent Notice
This document authorizes Bar Harbor Bank & Trust and Lake Sunapee Bank, a division of Bar Harbor Bank & Trust, to provide you with disclosures and other documents by delivering them electronically, rather than using paper disclosures.
- Scope of Communications to Be Provided in Electronic Form. This authorization acknowledges consent to provide electronic delivery of all documents and disclosures for all categories of products and services; including, but not limited to, all those pertaining to consumer loans. When you use a product or service to which this Disclosure applies, you agree that we may provide you with any communications in electronic format, and that we may discontinue sending paper communications to you, unless and until you withdraw your consent as described below. Your consent to receive electronic communications and transactions includes, but is not limited to:
- All legal and regulatory agreements, disclosures and communications associated with the features or services available through the online banking service for your Account
- Periodic or monthly statements for your Account
- Notices or disclosures about a change in the terms of your Account
- Privacy policies and notices.
- You have the option to have any particular document or disclosure made available on paper or in non-electronic form.
- You have the option to withdraw this consent at any time. If you withdraw consent, we will not be able to deliver disclosures or documents electronically and that may require termination or close-out of any products that require electronic delivery or it may impact the cost of those products if electronic delivery is a component of product pricing. You may withdraw your consent and there is no fee charged for the consent withdrawal.
- If you would prefer to receive paper copies free of charge after consenting to receive electronic disclosures and submitting your on-line application, you may: submit written instructions stating you revoke the authorization for electronic delivery and would prefer to receive all documents and disclosures in paper form. The written request must be mailed to: Community Banking, Bar Harbor Bank & Trust, PO Box 1089, Ellsworth, ME 04605. You may also email us at email@example.com or contact us by phone at 888-853-7100, please ask for Community Banking. Because we may provide certain disclosures to you immediately after submitting your on-line application, you will not be able to withdraw your consent to receive those disclosures electronically. However, you may withdraw your consent to receive future disclosures electronically at any time and at no cost to you by mailing, emailing us or contacting us by phone as described above. Such withdrawal will not affect the legal validity of the disclosures already given.
- To obtain a paper copy of any particular document or disclosure, you must mail a written request, specifying the document or disclosure you are requesting in paper form, to: Community Banking, Bar Harbor Bank & Trust, PO Box 1089, Ellsworth, ME 04605.
- Method of Providing Communications to You in Electronic Form. All Communications that we provide to you in electronic form will be provided either (1) via e-mail, (2) by access to a web site that we will designate in an e-mail notice we send to you at the time the information is available, which may link you to Communications contained in an account statement, or (3) to the extent permissible by law, by access to a web site that we will generally designate in advance for such purpose.
- You may exclude any particular category of records from electronic delivery by providing written notice stating the category of records to be excluded. Such request must be mailed to: Community Banking, Bar Harbor Bank & Trust, PO Box 1089, Ellsworth, ME 04605.
- Hardware and Software Requirements. In signing this form, you acknowledge you, and your systems, have the ability to save, print, and retain the electronic disclosures as some must be provided in a format that you can keep. If your systems do not have this ability, you must let us know so we can provide paper copies of those documents or disclosures. In order to access, view, and retain electronic Communications that we make available to you, you must have:
- an Internet browser that is capable of supporting 128-bit SSL encrypted communications, which includes the following recommended browsers,
- Microsoft Internet Explorer 11+
- Mozilla Firefox 44+
- Safari 8+
- Chrome 48+
- Edge (Windows 10 and higher)
- (Our site is optimized for use with certified/recommended browsers, as we may specify from time to time. If you use a different browser, you may not be able to take full advantage of all the features of our site.)
- sufficient electronic storage capacity on your computer's hard drive or other data storage unit;
- an e-mail account with an Internet service provider and e-mail software in order to participate in our electronic Communications programs;
- a personal computer, operating system and telecommunications connections to the Internet capable of receiving, accessing, displaying, and either printing or storing Communications received from us in electronic form via a plain text-formatted e-mail or by access to our web site using one of the browsers specified above.
Federal Law. You acknowledge and agree that your consent to electronic Communications is being provided in connection with a transaction affecting interstate commerce that is subject to the federal Electronic Signatures in Global and National Commerce Act (E-Sign Act), and that you and we both intend that the Act apply to the fullest extent possible to validate our ability to conduct business with you by electronic means.
I/We acknowledge I/we have read and understand this authorization and provide Lake Sunapee Bank, a division of Bar Harbor Bank & Trust, with this informed consent to deliver documents and disclosures to the e-mail address above.
FEDERAL CREDIT APPLICATION INSURANCE DISCLOSURE
I have applied for an extension of credit with you. You are soliciting, offering, or selling me an insurance product or annuity in connection with this extension of credit. FEDERAL LAW PROHIBITS YOU FROM CONDITIONING THE EXTENSION OF CREDIT ON EITHER.
- My purchase of an insurance product or annuity from you or from any of your affiliates; or
- My agreement not to obtain, or a prohibition on me from obtaining, an insurance product or annuity from an unaffiliated entity. By signing, I acknowledge that I have received a copy of this form on today's date. Unless this disclosure is provided electronically or I have applied for credit by mail, I also acknowledge that you have provided this disclosure to me orally.
PLEASE PRINT AND RETAIN A COPY OF THIS INFORMATION FOR YOUR RECORDS BEFORE YOU PRESS SUBMIT.