Credit Card Application

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an Account. What this means to you: When you open an Account, we will ask for our name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

APPLICANT

Note: All applicable sections should be filled out completely to avoid delay in processing your application.

Source of Additional Income: Income from alimony, child support or separate maintenance need not be revealed if it is not considered in determining creditworthiness.

CO-APPLICANT

center;">Information about co-applicant is not required for an individual account.

Last Name:

First Name:

Middle Name:

Social Security Number:

Date of Birth:

Home Phone Number:

Cell Phone Number:

Email:

Do you:

Own

Rent

Other

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Monthly Payment:

Current Address:

Current Address 2:

City:

State:

How Long (yrs):

Previous Address (if less than 2 years at present address):

Previous Address (if less than 2 years at present address) 2:

City:

State:

How long (yrs):

Employer Name:

Self Employed:

Yes

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Work Phone Number:

Date Employed:

Employer Address:

Home Mortgage/Rent

Bank Credit Card/Bank Name and Address

Interest Rates and Interest Charges	Visa^® Classic	Visa^®Gold	Visa^® Platinum
Annual Percentage Rate (APR) for Purchases	13.99%	11.99%	6.87%
APR for Balance Transfers	13.99%	11.99%	6.87%
APR for Cash Advances	13.99%	11.99%	10.87%
How to Avoid Paying Interest on Purchases	Your due date is at least days after the close of each billing cycle. We will not charge you any interest on purchases if you pay your entire balance by the due date each month.
Minimum Interest Charge	Your minimum interest charge is $5 for Visa^® Platinum and $0 for Visa^® Classic & Visa^® Gold
For Credit Card Tips from the Consumer Financial Protection Bureau	To learn more about factors to consider when applying for or using a credit card, visit the website of the Consumer Financial Protection Bureau at http://www.consumerfinance.gov/learnmore

Fees
Annual Fee	None
Transaction Fees Balance Transfer Cash Advance	None Up to $25
Penalty Fees Late Payment Over the Limit Returned Payment	Up to $25 None Up to $25

How we will calculate your balance: We use the method called “average daily balance (including new purchases).”
Billing Rights: Information on your rights to dispute transactions and how to exercise those rights is provided in your account agreement.

Other Disclosures
Late Payment:

Visa® Classic: $10 or the amount of the required minimum payment, whichever is less, if you are late in making your payment by the payment due date disclosed on your billing statement.
Visa® Gold: $10 or the amount of the required minimum payment, whichever is less, if you are late in making your payment by the payment due date disclosed on your billing statement.
Visa® Platinum: $25 or the amount of the required minimum payment, whichever is less, if you are late in making your payment by the payment due date disclosed on your billing statement.

Returned Check Fee:

Visa® Classic: $0
Visa® Gold: $20 or the amount of the required minimum payment, whichever is less.
Visa® Platinum: $25 or the amount of the required minimum payment, whichever is less.

Cash Advance Fee:

Visa® Classic: $0
Visa® Gold: $0
Visa® Platinum: $25

Rates, fees, and terms may change: Subject to the applicable restrictions, we may change the rates, fees, and terms of your account at any time for any reason. These reasons may be based on information in your credit report, such as your failure to make payments to other creditors when due, amounts owed to other creditors, the number of credit accounts outstanding or the number of credit inquiries. These reasons may also include competitive or market-related factors. If we make a change for any of these reasons, you will receive a 45-day advance notice in writing and a right to opt out in accordance with applicable law.

SIGNATURES

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING: This statement is submitted to obtain credit and I / we certify that all information herein is true and complete. I / We agree that inquiries 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 institution. I/ We agree to be bound by the terms and conditions of the cardholder 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 persumed 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. we may report information about your account to the credit bureau. Late payments, missed payments, or other defaults on your account may be reflected in your credit report.

Applicant Signature
Date

Co-Applicant Signature
Date

TRANSFER OF BALANCE REQUEST

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