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Privacy Notice
American Health and Life Insurance Company

Triton Insurance Company
Our goal is to maintain your trust and confidence when handling personal information about you.
You Have Choices: As a customer of Fairstone and American Health and Life Insurance Company
and/or Triton Insurance Company, you have the opportunity to make choices about how personal
information about you may be shared. As you consider this, we encourage you to make choices that enable
us to provide you with quality products and services that help you meet your financial needs and objectives.
Security Of Personal Information: The security of personal information about you is our priority. We
protect this information by maintaining physical, electronic, and procedural safeguards that meet applicable
law. We train our employees in the proper handling of personal information. When we use other companies
to provide services for us, we require them to protect the confidentiality of personal information they
receive.
Please note that any personal medical information, which you may be required to provide as part of the
creditor insurance application process or when submitting a claim for payment of benefits, will not be
shared with any of our affiliates or third parties for the purposes noted above.
Our Full Privacy Statement: You can view a copy of the American Health and Life Insurance Company
and/or Triton Insurance Company Privacy of Personal Information Statement on the website at
FairstoneCanada.ca. You may request a copy of the Privacy Statement, file an opt-out request to be removed
from our marketing lists or lists we may share with other parties, or request access to your personal
information by contacting us at the address or phone number below.
Any changes to the Privacy Statement and our information handling practices will be acknowledged in the
online Privacy Statement in a timely manner. We may add, modify or remove portions of the Privacy
Statement when we feel that it is appropriate to do so. You may determine when the Privacy Statement was
last updated by referring to the “Current” date displayed at the end of the Privacy Statement.

Triton Insurance Company1420 - 380 Wellington Street
London, Ontario N6A 5B5
Attention: Privacy Officer
Telephone: 1-800-285-8623
TM
© 2017 Fairstone. Fairstone is a trademark of Fairstone Financial Inc.
36728-3 (03/17) Original (Customer)

SCHEDULE 1
Cost of Borrowing (Banks) Regulations (SOR/2001-101)
Information Box
This Information Box contains a summary of key information about your loan. Please read the entire document for full details.
Principal Amount $11,147.78
Annual Interest Rate 35.9900%

Fixed rate per year.
Annual Percentage Rate 35.99 %

The interest rate for a whole year (annualized) including any non-interest fees (if
any).
Term 60 months
The term of the loan is open, which means that you can pay down all or a portion
of your loan at any time without any prepayment charge or penalty.
Date of Advance 07/27/2022

This is the date your funds will be advanced. Interest will be calculated and
charged from this date on. There are no grace periods.
Payments $402.73 on the 1st of every month

Your payment is payable monthly. All payments will be applied first to the
accumulated cost of borrowing, then to the outstanding Principal Amount, and
then to any other fees that are due.
Amortization Period 5 years and 0 months

Based on the current terms and conditions, your loan will take 5 years and 0
months to pay in full.
Prepayment Privilege You can pay down all or a portion of your loan at any time without any
prepayment charge or penalty.
Prepayment Charges Not applicable.
Default Insurance Not applicable.
Missed or returned or refused payment due to insufficient funds: $25.00 .

Other Fees
Lien Search and Recording Fee: $N/A . This fee is charged as of the Date of
Advance and has been included in the Principal Amount.
© 2022, ™Fairstone Financial Inc.

COST OF BORROWING NOTICE
This product is a form of high-cost credit.
Lender Fairstone Financial Inc.

License Number 349271
Date 07/27/2022
LOAN SUMMARY
TOTAL FEES AND

ANNUAL
INTEREST
CREDIT AMOUNT PERCENTAGE TERM OF
The total amount of TOTAL AMOUNT TO
The amount RATE (APR) AGREEMENT
fees and interest BE PAID
borrowed The cost of credit as a (in months)
associated with the
yearly rate
credit product
$11,147.78 $13,071.74 35.99% 60 $24,219.52
PAYMENT SCHEDULE*
CONTRACTUAL REGULAR PAYMENT DISHONOURED

START DATE
PAYMENT SCHEDULE AMOUNT PAYMENT FEE
Monthly 09/01/2022 $402.73 $25.00
*Refer to Page 1 of the loan contract for a detailed schedule of required payments.
Note: You cannot be forced to make scheduled payments before a payment is due under the credit agreement.
Prepayment: You can prepay this credit agreement in full or in part at any time without any charge or penalty.
Statement of Account: You can request a statement of account in writing from Fairstone.
For more information on your rights and protections, visit www.alberta.ca.
©2022 , ™Fairstone Financial Inc.

OPTIONAL SERVICES WITH LOAN
Optional services are opt-in only and may be cancelled at any time.
OPTIONAL SERVICES
Total Amount to be Paid Without Optional Services $21,718.47

Total Amount to be Paid Including Optional Services $24,219.52
TOTAL COST
CREDITOR CREDITOR JOB HOME AND OF ALL
CREDITOR LIFE
DISABILITY LOSS AUTO OPTIONAL
INSURANCE
INSURANCE INSURANCE SECURITY PLAN SERVICES
PURCHASED
COST NONE $1,147.78 NONE $NONE $1,147.78
TERM N/A 60 months N/A N/A
PAYMENT SCHEDULE*
CONTRACTUAL
START DATE NUMBER OF PAYMENTS PAYMENT AMOUNT
PAYMENT SCHEDULE
Monthly 09/01/2022 60 $41.46
*Refer to Page 1 of the loan contract for a detailed schedule of required payments.
Cancellation of Optional Insurance: You can cancel any optional insurance by either faxing or mailing to Fairstone a
written notice of cancellation. Such cancellation will be effective when received by Fairstone. If you cancel the optional
insurance, you are entitled to a pro-rated refund for any fees paid for any portion of the service that has not been
provided at the time of cancellation. If you cancel the optional insurance within 30 days of signing the loan, then the
cancellation will be effective the date of your loan, and you will receive a full refund of premium paid.
Cancellation of Home & Auto Security Plan: You can cancel the Home & Auto Security Plan by mailing, calling,
faxing, or emailing to Home & Auto Security Plan, Inc. a notice of cancellation. If you cancel the Home & Auto Security
Plan, you are entitled to a refund of the unearned membership fee, less the cost of products ordered. If you cancel the
Home & Auto Security Plan within 30 days of signing the loan, then the cancellation will be effective the date of your
loan, and you will receive a full refund of membership fees, less the retail cost of products not in new condition.
For more information on your rights and protections, visit www.alberta.ca.

PERSONAL LOAN AGREEMENT
BORROWER ("You") LENDER ("Us")

NONALYN DOMINGO ARELLANO Fairstone Financial Inc.
08/05/1978 Edson/610055
4421 6 Ave 103-330 45 Street
Edson, AB Edson, AB
T7E-1B6 T7E-1C3
Account Number* (67)6100554407170

*Use this account number to register and securely manage your loan, make payments and more at: www.account.fairstone.ca
Date of Loan The loan amount of $11,147.78 is being disbursed to you on 07/27/2022.
If you chose to receive the loan via electronic funds transfer, there may be a delay in this amount appearing in your
07/27/2022 bank account.
LOAN SUMMARY
Loan
Amount
Amount Paid to Amount Paid to (the amount paid to
Other Products Lien Search and Total Amount
You your Creditors you plus the amount Purchased Recording Fees Financed
paid to your
creditors)
$4,938.41 $5,061.59 $10,000.00 $1,147.78 N/A $11,147.78
Annual Total of Payments Cost of Credit

Total Amount Term of the
Annual Percentage Including Interest The amount that the loan will
Financed Loan cost you (interest plus search
Interest Rate (Amortization Period Rate (APR) The total amount you will repay if all
and registration fees if
The amount borrowed payments are made as scheduled
(in months)) The cost of credit as a applicable)
yearly rate
$11,147.78 35.9900% 60 35.99% $24,219.52 $13,071.74
DISBURSEMENT AND RE-PAYMENT INFORMATION

The amount of $4,938.41 will be paid to you via Electronic Fund Transfer (EFT), directly to your bank account:
Bank Account number: 5287594 Transit: 04359003 Amount: $4,938.41 NONALYN DOMINGO
ARELLANO
As a service to you, a cheque will be issued for payment of your accounts with the following creditors:
Creditor 1: Fairstone Amount: $5,061.59

RE-PAYMENT SCHEDULE
NUMBER OF PAYMENTS AMOUNT OF PAYMENTS WHEN PAYMENTS ARE DUE

1 $458.45 09/01/2022
59 $402.73 MONTHLY BEGINNING 10/01/2022
AUTHORIZATION TO HONOR FUNDS BY PERSONAL PRE-AUTHORIZED DEBITS (PAD)

To repay your loan, you have requested that we enroll you in Autopay, where we will debit the applicable amount directly from
your bank account on the scheduled payment date. You may cancel this service at any time by providing us with a written request.
Bank Account number: 5287594 Transit: 04359003
Payment Additional
Monthly Debit Schedule Total Debit Amount Start Date
Amount Amount
1st Extended Payment $458.45 $0.27 $458.72 09/01/2022
Regular Payment Amount $402.73 $0.27 $403.00 10/01/2022
Note: In the event that a payment is dishonored with or without cause, intentionally or inadvertently, we shall be under no
liability even if such rejection or dishonor results in the non-payment of your obligations, and you may be charged a fee of $25.00
for the rejection as applicable by law. If any 3 debits are dishonored by the bank for any reason within a 12-month period, or if any
2 debits are dishonored in a 3-month period, we may terminate this authorization.
You have certain recourse rights if any debit that we process does not comply with this agreement. For example, you have the
right to receive reimbursements for any debit that is not authorized or is not consistent with this agreement. To obtain more
information on your rights, contact your financial institution or visit www.cdnpay.ca.
2022-07-27 23:49:36 GMT

Borrower Signature: Date (yyyy-mm-dd):
OPTIONAL PRODUCTS
OPTIONAL INSURANCE COVERAGE
While the insurance products can help protect you from the effects of unexpected life events, it is not necessary to purchase any
insurance to qualify for this loan. Our decision to provide you with this loan is not affected by your decision to purchase optional
insurance, meaning you would qualify for this loan even if you choose not to buy any insurance products.
You may cancel any or all the optional insurance products you have purchased at any time. If we discover that you are ineligible
for the insurance purchased, the applicable insurance policy will be cancelled and any unearned portion of the premium applied to
your loan balance. If the insurance coverage(s) that you purchased should terminate for any reason, you authorize the insurance
company to deliver any applicable premium refund to us to be applied to the balance of your loan. This repayment won’t reduce
the re-payment amount but may reduce the number of payments required to fully pay off the loan. Please note that we may
realize a benefit from the sale of insurance.
CREDITOR LOAN PAYMENT

CREDITOR LIFE CREDITOR JOB LOSS LOAN PAYMENT
DISABILITY WITHOUT
INSURANCE INSURANCE WITH INSURANCE
INSURANCE INSURANCE
NONE $1,147.78 NONE $402.73 $361.27

No Coverage Single Coverage No Coverage
This loan is not protected with optional Creditor Life Insurance, therefore a claim may be placed against your estate to repay the
loan in the event of loss of life. N.A.
This loan is not protected with optional Creditor Job Loss Insurance, therefore full regular payments will be required even in the
event of reduced income due to job loss.

N.A.
Borrower Signature: Date (yyyy-mm-dd): 2022-07-27 23:49:00 GMT

LOAN TERMS
Promise to Repay: In return for the amount that you have received for this loan, you agree to repay the amount borrowed with
interest calculated at the Annual Interest Rate shown in the “Loan Summary”. The interest starts accruing on the date of the loan
and continues to accrue until the loan is repaid in full. When a payment is made on the account, the payment will be applied to
interest first, and the remaining payment to the principal amount. If all required payments have been made according to the
Re-Payment Schedule, the remaining balance at the end of the term will be $0. If payments are required beyond the final payment
date listed in section one, it does not count as an extension to this. If you prepay the entire outstanding balance under this loan,
we will provide a refund or credit of non-interest credit charges, if any, using the formula R= A x ((n-m)/n), where R is the amount to
be refunded or credited; A is the amount of any non-interest credit charges, except for disbursement charges, paid by you or
added to the balance; n is the period between the imposition of the non-interest credit charges and the scheduled end of the term
of the loan; and m is the period between the imposition of the non-interest credit charges and the prepayment.
Prepayment: Your loan is an open loan and can be paid off at any time without any fees or penalties. You can also make lump
sum payments to partially pay off the loan, and then interest will only be charged on the remaining balance. If you choose to make
a partial re-payment, your next scheduled payment, at the amount listed in the “Re-Payment Schedule” is still required until the
loan is paid off in full. A partial repayment does not reduce the amount per payment; however, it may reduce the total number of
payments in the “Re-Payment schedule”.
NSF Charges: We may charge a $25.00 fee if a payment is dishonored, and you agree to pay the fee upon request. Any NSF fees
will be added to the account balance.
Law that applies: This Personal Loan Agreement is governed by the laws of the province or territory where you live as shown on
your loan application and the laws of Canada applicable in that province or territory.
Default: You will be in default if the scheduled payments are not made on time; if you declare bankruptcy or are forced into
bankruptcy by another creditor; if any other creditor attempts to take your property through legal process; or if you have made a
false statement on your application or this loan agreement.
Effects of Default: In the event of default, we can, subject to applicable law, request full repayment of the outstanding principal
and accrued interest, and/or start a legal process against you, without prior notice, for repayment of any unpaid principal, interest,
accrued collection expenses and any reasonable legal fees we incur in attempting to collect a payment due under this loan
agreement. A delay in starting a legal process does not serve as a waiver of these rights.
Assignment: We can assign this loan agreement, in whole or in part, without notice to you or your consent. Any such assignee will
have all our rights under this loan agreement and such rights will not be subject to any claims, defences or set-offs that you may
have against us. You waive any defence to payment or right of set-off as against any assignee. You cannot assign this loan
agreement or any of your rights or obligations under it. This loan agreement shall apply to and bind you, your heirs, executors,
administrators, successors and any assignee we consent to and shall enure to the benefit of and may be enforced by us and our
successors and assignees.
By signing below, you agree to all of the terms above.
Borrower Signature: Date (yyyy-mm-dd): 2022-07-27 23:50:06 GMT
E-SIGNED by Crystal Whelan

Fairstone Loan Specialist: on 2022-07-27 23:51:11 GMT Date (yyyy-mm-dd): 2022-07-27 23:51:11 GMT

Consent:
In order to qualify for the loan, you provided us with consent to gather your credit history, personal or other information from
credit reporting agencies (also known as a hard credit pull) and to use the information for the reasons below:
v To perform a credit verification with the information you supplied in your loan application to determine your eligibility for
this loan
v To keep a file up to date with the gathered information by verifying your credit report regularly to continue and support
our ongoing business relationship
v Maintain the information for the purposes of collection on this loan or the fulfilment of any other obligation owed by you
to Fairstone.
You authorize us to contact you by phone using the telephone number(s) you have provided. In addition, we may record and
monitor your telephone conversations with our representatives for quality assurance, internal training and for record keeping
purposes.
You authorize us to exchange personal information regarding your account and insurance with Triton Insurance Company and
American Health and Life Insurance Company, with American Bankers Insurance company of Florida and American Bankers Life
Assurance Company of Florida, for the above purposes and generally for administering your loan and insurance.
Privacy: We will open a file containing your personal information. In addition to obtaining personal credit information about you
from credit reporting agencies, we may do so from other companies we deal with. We may exchange your personal information
with our affiliates, and with third party companies (some of which may be located outside of Canada) we use to service your
account. We may, provided you have not notified us to not send you such offers, promote our products or services, or those of our
affiliates or selected companies, to you via direct mail, or telephone, or other channels except via text message or email. We may
also disclose your personal information to third parties if required by law. To see our privacy statement and to learn more about
how we are keeping your information safe, please visit our website at www.fairstone.ca and click on the link for “Privacy and
security” or contact your branch for more information.
If you have provided us with your Social Insurance Number (SIN), you authorize and consent to our use of it for identification
purposes and to ensure an accurate match on your credit file with the credit reporting agencies.
2022-07-27 23:49:17 GMT

Borrower Signature: Date (yyyy-mm-dd):
I authorize Fairstone Financial Inc. to send me e-mail and/or text messages related to payments, general account servicing, for
collection purposes and to send me information about products and services that I may find useful.
Providing an e-mail address and/or cell phone number is entirely voluntary and you may contact us at any time to change your
consent choices.
Consent to receive text messages at (780) 600-0322 Borrower Signature:
Consent to receive e-mails to tart_forever05@yahoo.com Borrower Signature:

For Loan Customers of
Loan Protection Insurance Application for Unsecured Personal Loan
Optional Creditor Life Insurance is underwritten and issued by:
American Health and Life Insurance Companyin the course of its insurance business in Canada
Optional Creditor Disability and Job Loss Insurance is underwritten and issued by:
Triton Insurance Company in the course of its insurance business in Canada
1420-380 Wellington Street, London, Ontario N6A 5B5
Toll free 1-800-285-8623
(both referred to in this Application as “the Companies”)
The Life Insurance Group Policy No. 20200001
The Disability Insurance Group Policy No. 20200002
The Job Loss Insurance Group Policy No. 20200002
DETAILS OF YOUR LOAN
Creditor’s Name Creditor’s Branch Number Loan Account Number
Fairstone Financial
Inc. 0055 4407170
Original Loan Amount Original Monthly Loan Payment Loan Term Final Loan Payment
Payment (Principal & Interest) Due Date
$11,147.78 $402.73 60 Months 08/01/2027
SCHEDULE OF BENEFITS
Insured Borrower’s Name: Insured Co-Borrower’s Name:
NONALYN DOMINGO ARELLANO
Borrower’s Age: 43 Co-Borrower’s Age:
Borrower’s Date of Birth: 08/05/1978 Co-Borrower’s Date of Birth:
Effective Date : 07/27/2022 Expiration Date : 08/01/2027
Total Single Premium Insurance Amount $ 1,147.78 (if applicable, including taxes of $ 0.00 )
Life Insurance: Disability Insurance: Job Loss Insurance:
Life Insurance Premium: Disability Insurance Premium: Job Loss Insurance Premium:
$ 0.00 $ 1,147.78 $ 0.00
Initial Maximum Monthly Maximum Disability Monthly Maximum Maximum Job
Amount of Amount of Disability Monthly Waiting Job Loss Monthly Number of Loss
Life Life Benefit Disability Period Benefit Job Loss Monthly Job Waiting
Insurance Insurance Benefit Benefit Loss Period
Benefits
$N/A $N/A $402.73 $1,250.00 30 Days $N/A $N/A 12 Months 30 Days
Life Insurance Single Coverage Joint Coverage

If You die while this coverage is in effect We will pay an amount equal to the Insured Outstanding Balance on Your Loan at the time of
death. You must not reach age 71 before the Final Loan Payment Due Date to be eligible for this coverage.
X Disability Insurance X Single Coverage Joint Coverage
If You become Totally Disabled while this coverage is in effect and remain Totally Disabled for the number of days shown in the Waiting
Period in the Schedule of Benefits, We will pay a benefit for each day of Total Disability, not to exceed the Monthly Disability Benefit amount
shown in the Schedule of Benefits. To be eligible for this coverage, unless You are a Seasonal Worker, You must be working for salary or
wages at least 120 hours per month for one employer, and must not reach age 71 before the Final Loan Payment Due Date. Seasonal
Workers, to be eligible for this coverage, must have had their income verified by the Creditor using one of the approved methods for
Seasonal Workers and must not reach age 71 before the Final Loan Payment Due Date.
Involuntary Job Loss Insurance Single Coverage
If You have a Job Loss while this coverage is in effect and remain involuntarily unemployed for the number of days shown in the Waiting
Period in the Schedule of Benefits, We will pay a benefit for each day of Job Loss, not to exceed the Monthly Job Loss Benefit amount shown
in the Schedule of Benefits. To be eligible for this coverage, You must be working for salary or wages at least 120 hours per month for one
employer for the last 90 days, must be paying Employment Insurance (EI) premiums if working in Canada, and must not be self-employed,
seasonally employed, or an active member of the military . Note: in Quebec, You must also have purchased Disability Insurance to be
eligible for Job Loss Insurance.
If the age You or the Co-Borrower (if applicable) provided is incorrect and if either of You will reach the age of 71 before the Final Loan
Payment Due Date shown in the Schedule of Benefits, no insurance will be effective for Life or Disability under the Insurance Certificate. The
insurance coverages selected above are subject to the terms and conditions in the attached Insurance Certificate. There are limitations and
exclusions for this insurance. Please refer to the Insurance Certificate for a complete listing.
If You Change Your Mind

You have the right to cancel this coverage in writing any time. If You do so, You will not be able to buy any future insurance coverage for the
loan with the Original Loan Account Number shown above or for any renewal of a loan with the Creditor without completing a new insurance
application.
For additional information regarding cancellation of this insurance coverage, please refer to: www.americanhealthandlife.ca/concerns
or www.tritoninsurancecompany.ca/concerns.
My signature below confirms that:

• I meet the eligibility requirements as set forth above;
• I have requested loan protection insurance and meet the conditions of the insurance coverage set out in the attached Insurance
Certificate;
• I understand that I am not required to buy this insurance;
• The Creditor and/or its employees may receive compensation if I purchase this insurance;
• I understand that my coverage is subject to the terms and conditions on the attached Insurance Certificate;
• The decision to purchase this coverage was based on my own knowledge of the eligibility criteria; and
• I understand that the Creditor’s employees are not licensed insurance agents or salespeople and I have the right to seek advice
from a licensed insurance agent or salesperson.
Personal Information Authorization ( A photocopy of this authorization shall be as valid as the original)
App Personal Loans 37003-7

Original (Branch) Copy (Customer) Copy (Insurance Company)
1
I am aware of how to access the Companies’ Privacy of Personal Information Statement (“Privacy Statement”) online at
www.americanhealthandlife.ca. and/or www.tritoninsurancecompany.ca. Personal information will be collected, used, disclosed and
otherwise treated in accordance with the Privacy Statement, and as permitted or required by law. By signing and submitting this Application, I
acknowledge and consent to the Companies’ collection, use and disclosure of my personal information for the purposes identified in the
Privacy Statement.
For the purposes of claims investigation and processing, I authorize, consent, and direct any physician, medical practitioner, hospital, clinic
or other medical or medically-related facility, insurance company, or any other organization, institution, association or person identified in
the Privacy Statement that now has or may in the future have any records or knowledge concerning me, my health or my employment to
disclose to the Companies, their authorized representatives and re-insurers, upon the request of the companies, any such information that
is material to the purposes identified in the Privacy Statement.
2022-07-27 23:49:52 GMT
Signature of Borrower Date Signature of Co-Borrower Date

Ce document est disponible en français sur demande
App Personal Loans 37003-7

Original (Branch) Copy (Customer) Copy (Insurance Company)
2
For Loan Customers of
Your Insurance Certificate for Unsecured Personal Loan
Your Optional Creditor Life Insurance is underwritten and issued by:

in the course of its insurance business in Canada
Your Optional Creditor Disability and Job Loss Insurance is underwritten and issued by:
Triton Insurance Company in the course of its insurance business in Canada
1420 - 380 Wellington Street, London, Ontario N6A 5B5
Toll free 1-800-285-8623
The Life Insurance Group Policy No. 20200001
The Disability Insurance Group Policy No. 20200002
The Job Loss Insurance Group Policy No. 20200002
DETAILS OF YOUR LOAN
Creditor’s Name Creditor’s Branch Loan Account
Number Number
Fairstone Financial
Inc. 0055 4407170
Original Loan Amount Payment (Principal Final Loan Payment
& Interest) Due Date
$11,147.78 $402.73 60 Months 08/01/2027
SCHEDULE OF BENEFITS
Insured Borrower’s Name: Insured Co-Borrower’s name:
NONALYN DOMINGO ARELLANO
Borrower’s Age: 43 Co-Borrower’s Age:
Borrower’s Date of Birth: 08/05/1978 Co-Borrower’s Date of Birth:
Effective Date : 07/27/2022 Expiration Date: 08/01/2027
Total Single Premium Insurance Amount $ 1,147.78 (if applicable, including taxes of $ 0.00 )
Life Insurance: Disability Insurance: Job Loss Insurance:

Life Insurance Premium: Disability Insurance Premium: Job Loss Insurance Premium:
$ 0.00 $ 1,147.78 $ 0.00
Initial Maximum Monthly Maximum Disability Monthly Maximum Maximum Job

Amount of Amount of Disability Monthly Waiting Job Loss Monthly Number of Loss
Life Life Benefit Disability Period Benefit Job Loss Monthly Waiting
Insurance Insurance Benefit Benefit Job Loss Period
Benefits
$N/A $N/A $402.73 $1,250.00 30 Days $N/A $N/A 12 Months 30 Days
If You Change Your Mind
You have the right to cancel this coverage in writing at any time. If You cancel 31 or more days after the insurance
effective date, the premium refunds will be calculated according to the Rule of 78 except in Manitoba where the Pro
Rata method is used. If You decide to cancel, You will not be able to buy insurance coverage in the future for Your
Loan. If You renew Your Loan, You will have to fulfill eligibility requirements at that time.
For more detailed information contact:

American Health and Life Insurance Company and Triton Insurance Company
1420 - 380 Wellington Street, London, Ontario N6A 5B5
Toll free 1-800-285-8623
READ YOUR CERTIFICATE CAREFULLY. IT IS A LEGAL CONTRACT BETWEEN THE

COMPANY AND YOU.
Personal Loans 37004-7

Original (Branch) Copy (Customer)
1
Table of Contents
Schedule of Benefits 1
A Some Important Definitions 2
B When You Are Eligible For Insurance 3
C When You Are Covered 3
C1 When Your Insurance Begins 3
C2 When Your Coverage Ends 3
D Benefits Provided By This Insurance Certificate 4
D1 Life Insurance 4
D1.1 What We Will Pay 4
D1.2 What Is Not Covered (Exclusions) 4
D2 Disability Insurance 4
D2.2 When Payments Start 4
D2.3 What Is Not Covered (Exclusions and Limitations) 4
D2.4 Proof Of Disability 4
D3 Involuntary Job Loss Insurance 4
D3.2 When Payments Start 5
D3.3 What Is Not Covered (Exclusions and Limitations) 5
D3.4 To Make A Claim 5
E Information About This Insurance Certificate 5
E1 Misstating Your Age 5
E2 Making A Claim 5
E3 Legal Actions 6
E4 Contesting Your Coverage 6
E5 Our Right Under This Insurance Certificate 6
E6 Your Rights Under This Insurance Certificate 6
E7 Assignment 6
E8 If You Decide To Cancel Your Coverage 6
F Refund of Premiums 6
G How To Reach Us 7
A - Some Important Definitions

In this Insurance Certificate, the following definitions apply:
Accidental Injury
Means accidental bodily injury sustained by You after the Effective Date and which causes Your Total Disability.
Balance Owing
The balance owed on Your Loan on the loan payment due date prior to the date of Your death plus interest earned
from the last payment date to the date of death. Balance Owing does NOT include unearned interest or add-on
fees such as payout or penalty fees.
Creditor
The creditor whose name is shown on the first page of this insurance certificate. The Creditor is the Group
Policyholder.
Effective Date
The date insurance begins as shown in the Schedule of Benefits.
Expiration Date
The date Your insurance is scheduled to end as shown in the Schedule of Benefits.
Insured Outstanding Balance

The lesser of the Balance Owing or the Maximum Amount of Life Insurance shown in the Schedule of Benefits.
Job Loss
If You involuntarily lose Your Principal Job while this coverage is in effect for any one of the following reasons:
• lay-off - meaning Your employer suspends Your employment for a non-seasonal layoff;
• lockout - meaning Your employer temporarily closes Your place of employment without formally ending its
employment relationship with You and other employees; or
• employer termination - meaning Your employer ends its employment relationship with You.
Loan
Your Loan Account with the Creditor shown on the first page of this insurance certificate.

2
Pre-existing Condition
An illness, disease or physical condition for which medical diagnosis, advice, consultation or treatment was required
or recommended within the 6 month period immediately preceding the Effective Date and which causes Your Total
Disability within 6 months after the Effective Date.
Principal Job
A job where You are working for salary or wages at least 120 hours per month for one employer.
Seasonal Worker
An applicant whose income was verified by the Creditor utilizing one of the approved methods for Seasonal
Workers.
Sickness
Illness or disease which begins after the Effective Date and which causes Your Total Disability.
Total Disability/Totally Disabled

A disability caused by an Accidental Injury or by Sickness which continues uninterrupted for 30 or more consecutive
days and causes You to be unable to perform any duties of Your Principal Job. If You are a Seasonal Worker, the
disability would cause You to be unable to perform any duties of Your seasonal employment.
You and Your

Refers to the Insured Borrower, and, if there is one, the Insured Co-Borrower, as named in the Schedule of
Benefits, and for which a premium has been paid.
Waiting Period
The number of days shown in the Schedule of Benefits that You must remain Totally Disabled or unemployed to be
eligible for Disability or Job Loss benefits. If joint coverage is in effect, the Waiting Period will apply, even if the
other person insured is receiving benefits at that time.
We, Us and Our

Refers to American Health and Life Insurance Company or Triton Insurance Company .
B - When You Are Eligible For Insurance:

You are eligible for Life Insurance if:
• You have a Loan, and
• You will not reach Your 71 st birthday before the Final Loan Payment Due Date shown in the “Details Of Your
Loan”.
You are eligible for Disability Insurance if:
• You have a Loan,
• You are working at Your Principal Job on the Effective Date; or if a Seasonal Worker, Your income was
verified by the Creditor utilizing one of the approved methods for Seasonal Workers; and
• You will not reach Your 71st birthday before the Final Loan Payment Due Date shown in the “Details Of Your
Loan”.
You are eligible for Job Loss Insurance if:

• You have a Loan,
• You have Disability Insurance coverage on Your Loan (applies to Quebec residents only),
• You have been working at Your Principal Job on the Effective Date for the last 90 days,
• You have been paying Employment Insurance (EI) premiums, if working in Canada; and
You are not self-employed, seasonally employed, or an active member of the military
C - When You Are Covered

C1 When Your Insurance Begins
Your insurance begins on the Effective Date shown in the Schedule of Benefits .
C2 When Your Coverage Ends
The term of Your insurance is the same as the term of Your Loan, but shall not exceed 60 months.
Otherwise, Your insurance will end on the earliest of the following dates:
• the date Your Loan is refinanced, renewed or paid in full;
• the date Your Loan is charged off by the Creditor or is required to be charged off by law and the
creditor requests a refund of premium;
• the Final Loan Payment Due Date as shown in the Schedule of Benefits;
• the Expiration Date as shown in the Schedule of Benefits;
• the date You die;
• the date of a written cancellation request from You;
• the date the Group Policy is terminated;
• For Job Loss, the date the Disability Insurance on Your Loan ends (applies to Quebec residents
only); or
• the last day of the month in which the Creditor notifies Us that You are in default on Your Loan.

3
We have the option to terminate Your insurance if Your Loan is transferred to another creditor. If We
choose to terminate Your insurance in this situation, We will provide You with a written notice 30 days prior
to the termination date.
D - Benefits Provided By This Insurance Certificate

D1 LIFE INSURANCE
D1.1 Who is Covered

You have Life Insurance coverage if a premium for Life Insurance is shown on the Schedule of Benefits
section of this Insurance Certificate, and the premium is paid when due. If You have single coverage, only
the Insured Borrower is covered. If You have joint coverage, both the Insured Borrower and the Insured
Co-Borrower are covered.
D1.2 What We Will Pay

If You die while this coverage is in effect We will pay an amount equal to the Insured Outstanding Balance
on Your Loan at the time of death.
If the Original Loan Amount is more than the Maximum Amount of Life Insurance, the amount We will pay
will be based on the following formula:
Balance Owing at the time of death times the Maximum Amount of Life Insurance divided by the
Original Loan Amount.
If the Co-Borrower is insured under this insurance certificate, and both of You die, We will make a benefit
payment for only one of You.
D1.3 What Is Not Covered (Exclusions)

If either of You commit suicide within one year after the Effective Date, whether sane or insane, We will not
make a payment. Instead, We will cancel Your life insurance and refund the life insurance premiums.
D2 DISABILITY INSURANCE
D.2.1 Who is Covered

You have Disability Insurance coverage if a premium for Disability Insurance is shown on the Schedule of
Benefits section of this Insurance Certificate, and the premium is paid when due. If You have single
coverage, only the Insured Borrower is covered. If You have joint coverage, both the Insured Borrower and
the Insured Co-Borrower are covered. The Co-Borrower is not eligible for Disability Insurance in Quebec.

If Disability coverage is selected, Your Monthly Disability Benefit is the lesser of Your Original Monthly Loan
Payment and the Maximum Monthly Disability Benefit as shown in the Schedule of Benefits. If You become
Totally Disabled while this coverage is in effect and remain Totally Disabled for the number of days in the
Disability Waiting Period shown in the Schedule of Benefits:
• We will pay the Monthly Disability Benefit for each day of Total Disability beginning with the first day of
Total Disability. Daily Benefits will be calculated at 1/30 th of Your Monthly Disability Benefit.
• We will only pay a benefit for one Borrower, if both of You are insured and You both have a Total
Disability at the same time.
• We will pay the Monthly Disability Benefit if Your Total Disability ends and You become Totally Disabled
again from the same or related cause.
• Benefit payments will end on the earlier of: (i) the date You are no longer Totally Disabled; (ii) the
Expiration Date as shown on the Schedule of Benefits; or (iii) When Your Coverage Ends as shown in
section C2.
You will be responsible for the difference in payment due on Your Loan if Your Monthly Benefit is less than
Your current monthly loan payment.
D2.3 When Payments Start

Disability benefit payments will be made to the Creditor after You have been Totally Disabled for the number
of days in the Disability Waiting Period as shown in the Schedule of Benefits and after We receive proof of
Total Disability.

4
D2.4 What Is Not Covered (Exclusions and Limitations)
We will not pay a benefit if Your Total Disability is the result of any of the following:
• normal pregnancy;
• an Accidental Injury You suffer or Sickness You contracted outside of Canada or the United States of
America;
• a Pre-existing Condition;
• an act of war, whether or not war has been declared; or
• an intentional self-inflicted injury.
We will not pay benefits if Your Total Disability does not require regular treatment by a qualified physician. A
physician cannot be yourself, the co-borrower or a member of Your immediate family.
We will not pay benefits if You are not Totally Disabled.
D2.5 Proof Of Disability

You must give Us proof of Your ongoing Total Disability in the form We require and as often as We ask for it.
D3 INVOLUNTARY JOB LOSS INSURANCE
D.3.1 Who is Covered

You have Job Loss Insurance coverage if a premium for Job Loss Insurance is shown on the Schedule of
Benefits section of this Insurance Certificate, and the premium is paid when due. Job Loss Insurance is only
available for the Insured Borrower. The Co-Borrower is not eligible for Job Loss Insurance.

If Job Loss coverage is selected, Your Monthly Job Loss Benefit will be the lesser of Your Original Monthly
Loan Payment and the Maximum Monthly Job Loss Benefit as shown in the Schedule of Benefits. We will
not pay more than the Maximum Number of Job Loss Benefits as shown in the Schedule of Benefits. If You
have a Job Loss while this coverage is in effect and remain involuntarily unemployed for the number of days
in the Job Loss Waiting Period as shown in the Schedule of Benefits:
• We will pay the Monthly Job Loss Benefit for each day of Job Loss beginning with the first day of
unemployment. Daily Benefits will be calculated at 1/30 th of Your Monthly Benefit.
• Benefit payments will end on the earlier of: (i) the date You return to work; (ii) the date We have paid the
Maximum Number of Job Loss Benefits as shown in the Schedule of Benefits; (iii) the Expiration Date as
shown on the Schedule of Benefits; or (iv) When Your Coverage Ends as shown in section C2.
You will be responsible for the difference in payment due on Your Loan Account if Your Monthly Benefit is
less than Your current monthly loan payment.
D3.3 When Payments Start

Your Job Loss benefit payments start after You have been out of work for the number of days in the Job
Loss Waiting Period as shown in the Schedule of Benefits and We receive proof satisfactory to Us of Your
Job Loss.
D3.4 What Is Not Covered (Exclusions and Limitations)

We will not pay a benefit if You:
• Are laid off due to a normal and routine shut-down as determined by Your occupation or place of
employment and the shut-down is an annual or regularly-scheduled event after which You expect to be
rehired;
• Were aware on, or prior to, the Effective Date that You would lose Your job;
• Quit, take a voluntary leave of absence, retire or take an early retirement option;
• Lose Your job due to the expiration of a specified period of work or the completion of work where You
are employed under contract;
• Lose Your job due to an Accidental Injury or Sickness;
• Lose Your job due to the use of alcohol, narcotics or drugs;
• Lose Your job because You have either (i) broken a rule of action established by Your employer, (ii)
committed an act prohibited by Your employer, or (iii) purposely failed to do Your job duties as required
by Your employer;
• Lose Your job due to criminal misconduct;
• Are out on strike or lose Your job because You were on strike;
• Are seasonally employed;
• Lose Your job within 30 days of the Effective Date unless this insurance replaces previous insurance due
to the renewal or refinancing of Your Loan with the same Creditor and You have been insured for Job
Loss Insurance under the Group Policy without interruption; or
• If Your Job Loss happened while working outside of Canada or the United States of America.

5
D3.5 To Make A Claim
To make a claim, You must:
• lose Your Principal Job; and
• be out of work from Your Principal Job for the number of days in the Job Loss Waiting Period shown in
the Schedule of Benefits; and
• file, qualify for and receive regular benefits under the Canadian Employment Insurance Act and
regulations or the state unemployment agency of a U.S. state until such benefits are exhausted; and
• register with and seek work through Your Canada Human Resources Centre, equivalent Provincial
Centre or an independent employment agency or register for benefits from the state unemployment
agency of a U.S. state. You must register with an independent employment agency within 15 days after
the date Your Job Loss begins and remain registered while You are receiving benefits for Job Loss
benefits from Us.
In addition to sending Us the claim forms, You must also give Us:
• Your Employment Insurance (EI) benefit statement or the benefit statement from the state unemployment
agency in the U.S.; and
• verification from Your former employer, Canada Human Resources Centre, equivalent Provincial Centre,
or an independent employment agency or the state unemployment agency of a U.S. state of the
statements You made in Your claim; and
written proof that Your Job Loss continues when and as often as We ask for it.
E - Information About This Insurance Certificate

E1 Misstating Your Age
If Your age is incorrect and if either of You will reach the age of 71 before the Final Loan Payment Due Date
shown in the Details of Your Loan, no insurance will be effective under this Certificate.
If no claim has been paid this insurance certificate is voided and, We will refund to the Creditor any
premiums You have paid.
E2 Making A Claim
Notice of claim: You should notify Us of a claim within 60 days after the date of death, after the date Your
Total Disability begins or after the date Your Job Loss begins or as soon as reasonably possible.
We may not pay Your claim if You make a claim later than 3 years after the date of death or the date Your
Total Disability or Job Loss begins.
Claim forms: We will provide You with the forms necessary to file a claim within 15 days after You notify Us.
To whom We will make Our payments: We will pay any insurance benefits to the Creditor. The benefits
paid will be applied as payments on Your Loan or, in case of Life Insurance, to reduce the outstanding
balance of Your Loan.
The Creditor may not act on Our behalf to settle any claim.
All benefit payments are made in Canadian dollars.
This Certificate contains a provision removing or restricting the right of the group person insured to
designate persons to whom or for whose benefit insurance money is to be payable. If You have
questions, You may contact Your branch, notify Us in writing, or call Us.
E3 Legal Actions
Quebec:
Every action or proceeding against an insurer for the recovery of insurance money payable under the
contract is absolutely barred unless commenced within the time set out in The Civil Code of Quebec.
All Other Provinces:

Every action or proceeding against an insurer for the recovery of insurance money payable under the
contract is absolutely barred unless commenced within the time set out in the applicable provincial
legislation: In Alberta - Insurance Act; In British Columbia, New Brunswick, Nova Scotia, Prince Edward
Island, Yukon, Northwest Territories and Nunavut - Insurance Act; In Manitoba - The Insurance Act; In
Ontario - Limitations Act of 2002; In Saskatchewan and Newfoundland - The Limitations Act.
E4 Contesting Your Coverage

We may not contest Your coverage as the result of any statement signed by You for this insurance, after the
coverage has been in effect for 2 years, except in cases of fraud.
E5 Our Rights Under This Insurance Certificate

Your coverage is subject to the terms and conditions described in this insurance certificate. We may choose
not to apply any of the conditions or rights We have under this insurance certificate. If We do so, it will not
prevent Us from applying them in the future. Also it will not affect in any way any other conditions or rights to
which We are entitled.
6
The terms of this Insurance Certificate may be changed by Us by an endorsement or an amendment to the
Group Policy which is agreed to in writing by the Creditor and which will become effective 30 days after
written notice is provided to You.
E6 Your Rights Under This Insurance Certificate

You have the right to obtain copies of Your application and any written statement or other record, not
otherwise part of the application, provided to Us as evidence of Your insurability.
You also have the right to access the non-confidential parts of the Group Policies referenced at the start of
this certificate.
E7 Assignment
Our written consent must be obtained before the interest of the Creditor and/or Debtor in the: (a)
Group Policy; (b) Certificate of Insurance; (c) or any part thereof, is assignable. Our liability under
the Group Policy and/or this Certificate of Insurance shall immediately cease in the event of transfer
or assignment of such interest without Our consent.
E8 If You Decide To Cancel Your Coverage

You have the right to cancel this coverage in writing at any time.
If You cancel the coverage within 30 days after the Effective Date, You will receive a full credit to Your
account for the premium charged.
If You cancel 31 or more days after the Effective Date, We will refund in accordance with Refund of
Premiums below.
F Refund of Premiums
If this insurance ends before the end of the term of Your Loan, We will refund any unused premium.
Premium refunds are calculated according to the Rule of 78 method, except in Manitoba where the Pro Rata
method is used.
We will also refund any premiums You have paid for any period or amounts that are not part of Your
coverage.
If Your insurance ends because We have paid a death benefit, no life premiums will be refunded.
Rule of 78
The percentage of Your premium that We will refund under this method is calculated as follows. The
terms are measured in months.
(Remaining term of Your Loan) x (Remaining term of Your Loan + 1)

(Original term of Your Loan) x (Original term of Your Loan + 1)
This percentage is then multiplied by the original premium charged for the coverage that is being
ended. We will pay this amount to the Creditor who will either credit it to Your account or pay it to
You.
Pro Rata
The percentage of Your premium that We will refund under this method is calculated as follows. The
terms are measured in months.
(Remaining term of Your Loan)

(Original term of Your Loan)
This percentage is then multiplied by the original premium charged for the coverage that is being
ended. We will pay this amount to the Creditor who will either credit it to Your account or pay it to
You.
G How To Reach Us
Customer Inquiries
Customer satisfaction is important to Us. If You have any questions regarding Your insurance or Our policies
and procedures, please contact:
American Health and Life Insurance Company and Triton Insurance Company
1420 - 380 Wellington Street
London, Ontario
N6A 5B5
Toll free 1-800-285-8623
If We are unable to resolve Your questions to Your satisfaction, You have the right to contact the
OmbudService for Life and Health Insurance toll free at 1-888-295-8112.

7
David Torrence
Chief Agent for Canada
Ce document est disponible en français sur demande

8
Refer a friend and get $100!
Hello NONALYN DOMINGO ARELLANO,
We appreciate your business and would like the opportunity to provide the same one-on-one, expert service to
your family and friends. Refer someone you know and help them get the money they need when they need it,
and receive $100 as a thank you for your referral*.
Here’s how it works:
1) Refer someone to Fairstone. Give them your unique Referral Number (found at the bottom of this letter)
and have them contact a branch. Anyone you refer needs to provide this number when they apply for a
personal loan.
2) One of our Loan Specialists will work with them to design a personalized loan solution.
3) When anyone you refer closes a new personal loan with Fairstone, you’ll receive a $100 referral reward
as our thanks*.
Fairstone offers personalized loan solutions with manageable monthly payments and a fixed interest rate. Call
us today for more information or visit us online at FairstoneCanada.ca.
Your Fairstone Loan Specialist,

Crystal Whelan (780) 712-3033
Clip and share these cards with your family and friends and receive a $100 referral reward as our thanks*.
Get the money you need Get the money you need Get the money you need Get the money you need
when you need it. when you need it. when you need it. when you need it.
Rely on Fairstone for: Rely on Fairstone for: Rely on Fairstone for: Rely on Fairstone for:
• One-on-one, local service • One-on-one, local service • One-on-one, local service • One-on-one, local service
• Manageable monthly • Manageable monthly • Manageable monthly • Manageable monthly
payments payments payments payments
• Fixed rates for the life of • Fixed rates for the life of • Fixed rates for the life of • Fixed rates for the life of
your loan your loan your loan your loan
Referred by: Referred by: Referred by: Referred by:

NONALYN DOMINGO ARELLANO NONALYN DOMINGO ARELLANO NONALYN DOMINGO ARELLANO NONALYN DOMINGO ARELLANO
Referral Number: Referral Number: Referral Number: Referral Number:

1000-0006-5572-1105 1000-0006-5572-1105 1000-0006-5572-1105 1000-0006-5572-1105
Call, click or visit your branch. Call, click or visit your branch. Call, click or visit your branch. Call, click or visit your branch.
FairstoneCanada.ca FairstoneCanada.ca FairstoneCanada.ca FairstoneCanada.ca
877-836-2484 877-836-2484 877-836-2484 877-836-2484
Terms and Conditions Apply. Offer Terms and Conditions Apply. Offer Terms and Conditions Apply. Offer Terms and Conditions Apply. Offer
not available in Quebec. not available in Quebec. not available in Quebec. not available in Quebec.
© Fairstone 2017. Fairstone™ is a trademark of Fairstone Financial Inc. Used under license.
“Terms & Conditions: Not available to residents of Quebec. You may qualify to earn a referral reward (“Reward”) if the
person you refer (“Referee”) obtains an unsecured personal loan from Fairstone. Referee must provide the referral
number to Fairstone prior to loan closing. To be eligible, Referee cannot have an existing loan at the time the Referee
closes their loan. Reward is a cheque that will be mailed 6-8 weeks after Referee’s loan closing. Reward will not be paid
for loans that are paid in full within 30 days of origination, cancelled, or in which you are the primary borrower. Limit five
Rewards per customer per calendar year. In order to protect customer privacy, Fairstone cannot provide any information
about the status of Referee’s loan application. Fairstone reserves the right to discontinue the program at any time for any
reason. You are responsible for payment of any income or other taxes due as a result of the Reward having been paid to
you.”
CN5012B-3 3/2017

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American Health and Life Insurance Company

American Health and Life Insurance Company

36728-3 (03/17) Original (Customer)

Principal Amount $11,147.78

Annual Interest Rate 35.9900%

Annual Percentage Rate 35.99 %

Date of Advance 07/27/2022

Payments $402.73 on the 1st of every month

Amortization Period 5 years and 0 months

Prepayment Charges Not applicable.

Default Insurance Not applicable.

Missed or returned or refused payment due to insufficient funds: $25.00 .

© 2022, ™Fairstone Financial Inc.

Lender Fairstone Financial Inc.

TOTAL FEES AND

CONTRACTUAL REGULAR PAYMENT DISHONOURED

For more information on your rights and protections, visit www.alberta.ca.

©2022 , ™Fairstone Financial Inc.

Total Amount to be Paid Without Optional Services $21,718.47

TERM N/A 60 months N/A N/A

For more information on your rights and protections, visit www.alberta.ca.

© 2022, ™Fairstone Financial Inc.

BORROWER ("You") LENDER ("Us")

Account Number* (67)6100554407170

$4,938.41 $5,061.59 $10,000.00 $1,147.78 N/A $11,147.78

Annual Total of Payments Cost of Credit

$11,147.78 35.9900% 60 35.99% $24,219.52 $13,071.74

DISBURSEMENT AND RE-PAYMENT INFORMATION

Creditor 1: Fairstone Amount: $5,061.59

© 2022, ™Fairstone Financial Inc.

NUMBER OF PAYMENTS AMOUNT OF PAYMENTS WHEN PAYMENTS ARE DUE

59 $402.73 MONTHLY BEGINNING 10/01/2022

AUTHORIZATION TO HONOR FUNDS BY PERSONAL PRE-AUTHORIZED DEBITS (PAD)

1st Extended Payment $458.45 $0.27 $458.72 09/01/2022

Regular Payment Amount $402.73 $0.27 $403.00 10/01/2022

2022-07-27 23:49:36 GMT

OPTIONAL INSURANCE COVERAGE

CREDITOR LOAN PAYMENT

NONE $1,147.78 NONE $402.73 $361.27

loan in the event of loss of life. N.A.

event of reduced income due to job loss.

Borrower Signature: Date (yyyy-mm-dd): 2022-07-27 23:49:00 GMT

© 2022, ™Fairstone Financial Inc.

By signing below, you agree to all of the terms above.

Borrower Signature: Date (yyyy-mm-dd): 2022-07-27 23:50:06 GMT

E-SIGNED by Crystal Whelan

© 2022, ™Fairstone Financial Inc.

2022-07-27 23:49:17 GMT

Consent to receive text messages at (780) 600-0322 Borrower Signature:

Consent to receive e-mails to tart_forever05@yahoo.com Borrower Signature:

© 2022, ™Fairstone Financial Inc.

Life Insurance Single Coverage Joint Coverage

If You Change Your Mind

My signature below confirms that:

App Personal Loans 37003-7

2022-07-27 23:49:52 GMT

Signature of Borrower Date Signature of Co-Borrower Date

App Personal Loans 37003-7

Your Optional Creditor Life Insurance is underwritten and issued by:

$11,147.78 $402.73 60 Months 08/01/2027

Effective Date : 07/27/2022 Expiration Date: 08/01/2027

Life Insurance: Disability Insurance: Job Loss Insurance: