Credit Card Choice:
Check
Account Choice:
Credit
Limit Requested:*
Applicant: Note:
All Applicable Sections Should Be Filled Out Completely.
If Not, Processing Of Your Application May Be Delayed.
Last
Name:* First:* Middle
Initial:* Birth
date:*
Social
Security Number:* No.
Of Dependants:* Home
Phone:*
Rent
Or Own: Rent
Monthly
Payment:* E-Mail:*
Current
Address:* City:* State:* Zip:*
How
Long:*
Mailing
Address: (if different)* City:* State:* Zip:*
How
Long:*
Previous
Address: (if different)* City:* State:* Zip:*
How
Long:*
Employer:* Business
Phone:* No.
of Years:*
Business
Address: * City:* State:* Zip:*
Position/Occupation:* Monthly
Gross Income:*
Previous
Employer:*
Previous
Employer Address: * City:* State:* Zip:*
Source
of Additional Income:* Amount
Per Month:*
Name
of Closest Relative Not Living with You:* Home
Phone:* *
Relative's
Address: * City:* State:* Zip:*
*
You Need Not Furnish Alimony, Child Support or Maintenance
Income Information If You Do Not Want Us To Consider It
In Evaluating Your Application.
Co-Applicant: Note:
Complete This Section Only If Co-Applicant Is Applying
For a Joint Account.
Last
Name: First: Middle
Initial: Birth
date:
Social
Security Number: No.
Of Dependants: Home
Phone:
Please Select
Own
Rent
Other
Monthly
Payment:
Current
Address: City: State: Zip:
How
Long:
Mailing
Address: (if different) City: State: Zip:
How
Long:
Previous
Address: (if different) City: State: Zip:
How
Long:
Employer: Business
Phone: No.
of Years:
Business
Address: City: State: Zip:
Position/Occupation: Monthly
Gross Income:
Previous
Employer:
Previous
Employer Address: City: State: Zip:
Source
of Additional Income: Amount
Per Month:
C redit
Information
Bank
Name and Address:* City:* State:* Zip:*
Branch:* Loans:
Closed
Checking
Account Number/Name Listed: * Savings
Account Number/Name Listed: *
1.
Automobile
Name
and Address of Creditor: *
City: * State: * Zip: *
Account
Number: * Balance: * Monthly
Payment: *
2.
Home Mortgage
Name
and Address of Creditor:
City: State: Zip:
Account
Number: Balance: Monthly
Payment
3.
Bank Credit Card/Bank Name and Address
Name
and Address of Creditor:
City: State: Zip:
Account
Number: Balance: Monthly
Payment
4.
Other
Name
and Address of Creditor:
City: State: Zip:
Account
Number: Balance: Monthly
Payment
C redit
Disclosures
Annual
Percentage Rate For Purchases: 11.88%
Annual
Membership Fee: $12.00
Grace
Period For Purchases: 25
Days *
Method
Of Computing The Balance For Purchases: Average
Daily Balance Including New Purchases *
Late
Payment Fee: $10.00
Over
The Limit Fee: $10.00
Cash
Advance Fee: None
No
Minimum Finance Charge
No
Balance Transfer Fee
At
the date this application was created, the information listed
above was accurate.contact
us for the current information.
*
A Finance Charge will be imposed on Credit Purchases only
if you elect not to pay the entire New Balance shown on
you monthly statement for the previous billing cycle within
25 days from the closing date of that statement. If
you elect not to pay the entire New Balance shown on you
previous monthly statement within that 25 day period,
A Finance Charge will Be imposed on the unpaid average daily
balance of such Credit Purchases from the previous statement
losing date and on new Credit Purchases from the date of
posting to you account during the current filling cycle,
and will continue to accrue until the closing date of the
billing cycle preceding the date on which the entire New
Balance is paid in full or until the date of payment if
more that 25 days from the closing date.
Please
Read Carefully Before Submitting: This application is submitted
to obtain credit and I/We certify that all information herein
is true and complete. I/We agree that inquires may
be made to verify information and that credit references
or verification may be given based on inquiries from other
parties. This offer is subject to the credit policies
of this intuition. I/We agree to be bound by the terms
and conditions of the bank card agreement, a copy of which
will be mailed to the applicant if this application is granted,
receipt of such agreement and acceptance of such terms to
be conclusively presumed by the applicant's use. If
this is a joint application, the undersigned shall be jointly
and severally liable for any and all credit extended from
time to time.
