Credit Application

Credit Application

Credit Application
Adrian Williams & Ashley Chavez • SWS-2026-00142
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Credit Application Variables Customer name + property fields are shared with the Sales Agreement; everything else is credit-app specific.
Applicant (Adrian Williams)
Co-Applicant (Ashley Chavez)

CREDIT APPLICATION

PROPERTY INFORMATION
Property Address
7103 North 45th Avenue
City
Glendale
State
AZ
Zip
85301
Monthly Payment
$1,000.00

I certify that the above statements are true and completely accurate and that no unfavorable information known to me for use herein has been omitted.

I understand that I am considering purchasing certain water treatment products and services from Serenity Water Systems ("SWS"). By submitting your request for credit electronically each of you certify that (i) all of the statements made in this Application Information form or verbally communicated to SWS or SWS's Associates are true and correct and are made for the purposes of obtaining credit and (ii) if more than 1 Applicant, none is a co-signer. Further, you authorize SWS and/or its assigns and the Lender to: (1) obtain a credit report on you for any legal purpose in connection with this loan application, including any update, extension of credit, review or collection of your loan, and (2) lender will notify SWS of the credit decision and (if approved) the proposed loan repayment period. If you request, you will be informed whether any credit report was requested, and if so, the name and address of the consumer reporting agency furnishing this report. You agree to provide additional financial information upon request. By submitting this loan application, you expressly authorize the shared disclosure of loan-related information, including, but not limited to, your credit decision, proposed loan terms and personal credit scores, to any co-applicant or co-borrower, which will have the same effect as personal delivery to you.

By signing this application, you are acknowledging and/or agreeing to this E-Sign Consent & Disclosure (or by otherwise taking an affirmative action indicating your agreement to this E-Sign Consent & Disclosure), you agree that: (i) you have received, read, and agree to all of the terms of this E-Sign Consent & Disclosure; and (ii) you consent to electronic delivery of all communications for and relating to your project, products, and services offered or accessible through Serenity Water Systems ("Serenity").

I understand that if credit is denied, I am entitled to a clear and meaningful statement in writing of the reasons. Any reproduction of this Authorization for Release of Credit Information made by reliable means (for example, photocopy or facsimile) is considered an original.

Signature (Adrian Williams)
June 24, 2026
Date
Passport
C22411801
Issuing Authority
US
Issue Date
03/14/2024
Expiration Date
03/13/2034
Signature (Ashley Chavez)
June 24, 2026
Date
Drivers License
D05338874
Issuing Authority
AZ
Issue Date
06/08/2022
Expiration Date
03/08/2056

Privacy Act Notice Statement: This notice is provided to you pursuant to the Privacy of Consumer Financial Information Act and the Federal Trade Commission's implementing regulation thereunder, 16 CFR Part 313. 1. Collection Sources: We collect nonpublic information about you from the following sources: Information we receive on your applications or other forms; Information about your transactions with us, our affiliates or others; And Information we receive from a consumer reporting agency. 2. We do not disclose any nonpublic personal information about our customers or former customers to anyone, except as permitted by law. We restrict access to nonpublic personal information about you to those employees who need to know what information to provide the requested loan origination services to you. We maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information. USA Patriot Act, Section 326 Verification of Identification: The regulation shall, at a minimum require financial institutions to implement, and customers to comply with reasonable procedures for verifying the identity of any person seeking to open an account to the extent reasonable and practicable.

June 24, 2026
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