Mortgage Application

First State is required by Federal law to obtain, verify and record information that identifies each customer who opens an account with us. When you open your account with us, we will ask you for your name, address, and other information that will allow us to identify you, such as photo identification, social security number and date of birth.

Agreement Between You and First State.
By accessing this web site you (meaning any individual whose name is used in the prequalification pages, jointly and severally; also referred to herein as "your") agree to and accept, without modification, the terms, conditions, and notices contained in this Agreement. We reserve the right to revise these Terms of Use and Disclosures from time to time without notice by posting such change on the site. Any such change will be effective immediately upon posting on this web site. If you do not wish to be bound by these terms and conditions, you may not access or use this web site. Further, these terms and conditions apply exclusively to your access to, and use of, this web site and do not alter in any way the terms and conditions of any other agreement you may have with us. Notwithstanding any of these terms and conditions, we reserve the right, without notice and in our sole discretion, to block or prevent future access to and use of this web site.

Federal Disclosures
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, age (provided the applicant has the capacity to enter into a 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. The federal agency that administers compliance with this law concerning this creditor is The Federal Deposit Insurance Corporation, Customer Assistance Unit, 2345 Grand, Suite 100, Kansas City, MO 64108.

Security Policy
We and our providers are committed to protecting the security of your information. Although we have taken certain steps to ensure that your personal information is delivered and disclosed only to us, we cannot guarantee that the personal information you provide will not be intercepted by others.

Disclaimers and Limitations
We do not warrant that the information contained in this web site is at all times accurate and reliable; an error sometimes occurs. We expressly disclaim any obligation to update the contents of this web site or to maintain uninterrupted access to this web site. Reference to any products, services, processes, or other information, by trade name, manufacturer, supplier, or otherwise does not constitute or imply endorsement, sponsorship or recommendation thereof by us.

THIS WEB SITE AND THE MATERIALS CONTAINED ON THIS WEB SITE ARE PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS WITHOUT WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED BY US. WE DISCLAIM ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO, IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE AND NON-INFRINGEMENT. WE DO NOT REPRESENT OR WARRANT THAT MATERIALS IN THIS WEB SITE ARE ACCURATE, COMPLETE, CURRENT, OR ERROR-FREE. WE DO NOT REPRESENT OR WARRANT THAT THIS WEB SITE OR ITS SERVER(S) ARE FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS. WE SHALL NOT BE LIABLE FOR ANY DAMAGES, SERVICES, REPAIRS OR CORRECTIONS THAT MUST BE PERFORMED ON YOUR COMPUTER CAUSED BY YOUR USE OF THIS WEB SITE, INCLUDING ANY INFECTION OF VIRUSES.

IN NO EVENT SHALL WE LIABLE FOR ANY DIRECT, SPECIAL, INDIRECT OR CONSEQUENTIAL DAMAGES, OR ANY OTHER DAMAGES OF ANY KIND, INCLUDING BUT NOT LIMITED TO LOSS OF USE, LOSS OF PROFITS, OR LOSS OF DATA, WHETHER IN AN ACTION IN CONTRACT, TORT (INCLUDING BUT NOT LIMITED TO NEGLIGENCE), OR OTHERWISE, ARISING OUT OF OR IN ANY WAY CONNECTED WITH THE USE OF THIS WEB SITE OR THE MATERIALS CONTAINED IN, OR ACCESSED THROUGH, THIS WEB SITE.

Links to Third Party Web Sites
From time to time, this web site may contain links to other web sites maintained by third parties. We do not own, operate or endorse these web sites. These links are provided for your convenience and reference only. We have not reviewed all web sites linked to this web site and are not responsible for the content of off-web site pages. Linking to any other web sites is at your own risk. We do not make any representations about, accept any liability for, or sponsor any of the programs, information, content or advertisements contained on, distributed through, or linked, downloaded or accessed from any linked web sites, nor the quality of any products, information or other materials displayed, purchased, or obtained by you therefrom or as a result of an advertisement or offer thereon.

Errors and Delays
We are not responsible for any errors or delays in responding to your request for credit. caused by incorrect information provided by you or by other technical problems beyond our reasonable control.

Applicable Law
This Agreement shall be subject to the laws of the United States as applicable to state chartered banks, and to the extent said laws do not apply, then this Agreement is governed by the laws of the State of Tennessee, applicable to agreements made and entirely to be performed within such state, without resort to its conflict of law provisions. You agree that any action at law or in equity arising out of or relating to these terms and conditions shall be filed only in Tennessee state court and you hereby irrevocably and unconditionally consent and submit to the exclusive jurisdiction or such courts over any suit, action or proceeding arising out of this Agreement or the terms and disclosures.

Reservation of Rights
The availability of any logos, graphics or icons through this web site shall under no circumstance constitute a transfer of any copyrights, trademarks or other intellectual property rights of us to any web site user or third party. The First State logo may not be copied, imitated or used without the express prior written permission of First State. Other products and companies referred to herein are trademarks or registered trademarks of their respective companies or mark holders.

Copyright and Trademark Notices
All contents of this web site are: Copyright © 2004 First State. All rights reserved.

Electronic Notices Disclosure and Consent
This Electronic Notices Disclosure and Consent ("Consent") contains important information about how we will deliver to you disclosures and notices required by applicable law relating to your request for a First State loan and related services made available. Such notices may include loan application disclosures, our initial privacy notice and all communications about your application and request for related services. (We will call any such disclosures and all other such communications with you a "Notice.")

This is your copy of the Consent. Please read it carefully and print and retain a copy for your records.

Consent to Electronic Notices: By clicking on the "I Agree" button below, you agree to receive, and acknowledge that you can access, receive and retain, all Notices electronically, whether sent by e-mail or other electronic means. You further acknowledge that by accessing the First-state.net website, you satisfy the hardware and software requirements described below. Accordingly, you acknowledge that you reasonably demonstrate that you can access, receive and retain Notices electronically, regardless of whether a Notice is posted on the first-state.net website, or is sent to you by e-mail or other electronic means.

The decision to do business electronically is yours.
Receiving Electronic Notices: With appropriate notice to you as permitted by applicable law, we may post Notices on the first-state.net website, for at least 90 days. We will consider any such Notice received when sent even if you do not receive the e-mail or access the first-state.net website, during the time it is available. You agree to notify us promptly if your mailing address, e-mail address or other information changes by calling us at 731-885-7090, or writing to us at Online Loan Sales, Online Banking Department, 115 W. Washington Avenue, Union City, TN 38261.

Hardware and Software Requirements: In order to access, receive and retain Notices electronically, you must satisfy the hardware and software requirements described below. We will give you Notice of any change to these requirements if the proposed change will adversely affect your ability to access, receive and retain subsequent electronic Notices from us. Following are the hardware and software requirements, which you must satisfy at your own expense.
  1. An Internet web browser which is SSL-compliant and has a "secure mode," such as America Online®, Netscape or Internet Explorer. While SSL will protect your security, the site looks and works best with the following SSL browser versions:
    Windows
    Netscape Navigator 6.0 or later
    Netscape Communicator 6.0 or later
    Microsoft Internet Explorer 5.0 or later
    Macintosh
    Netscape Navigator 6.0 or later
    Netscape Communicator 6.0 or later
    Microsoft Internet Explorer 5.0 or later

  2. Access to the Internet through an Internet or other service provider;

  3. An e-mail account and e-mail software capable of interfacing with first-state.net website, such as AOL MailSM, MSN Hotmail or Yahoo!® Mail;

  4. A personal computer, operating system and all necessary telephone lines, Internet or other connections and equipment capable of supporting the foregoing, including any Internet-enabled wireless devices, such as personal digital assistants and cellular telephones you may use to access the first-state.net website; and

  5. Sufficient electronic storage capacity on your computer's hard drive or other data storage unit, or a printer that is capable of printing from your Internet web browser and e-mail software.
Withdrawal of Consent to Electronic Notices: If you consent to receive Notices electronically, you can withdraw your consent at any time by calling us at 731-885-7090, or writing to us at Online Loan Sales,Online Banking Departement, 115 W. Washington Avenue, Union City, TN 38261. You will not be charged a separate fee if you choose to withdraw your consent; however, your access to, and use of the first-state.net website to receive Notices, will automatically be terminated and your user name and password will be deactivated. Termination of the Consent will not affect the legal effect of any Notice, electronic or otherwise, before the Consent is terminated.

Important Information About Procedures For Opening Or Changing An Account With First State

Section 326 of the USA PATRIOT ACT requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account or changes an existing account. This federal requirement applies to all new customers and current customers. This information is used to assist the United States government in the fight against the funding of terrorism and money-laundering activities.

What this means to you: when you open an account or change an existing account, we will ask each person for their name, physical address, mailing address, date of birth, and other information that will allow us to identify them. We will ask to see each person's driver's license and other identifying documents and copy or record information from each of them.

DO NOT SUBMIT THIS FORM UNTIL YOU CAREFULLY READ IT AND UNDERSTAND ITS CONTENT

Once you have submitted your application for processing, you will be contacted within 48 hours to meet with a Customer Service Representative. At this time, they will help you finish your account process at the First State location of your choice.

Please call the First State nearest you now if you have any questions - we'd be glad to walk you through the process or meet with you in person when you are ready.

Purpose
You are about to submit an application for a loan. You must still meet with a First State loan officer to complete the loan process. 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 Insurance Disclosure
  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 SUBMITTING THIS FORM, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THIS INSURANCE DISCLOSURE.