Members United Credit Union
 
VISA APPLICATION
Credit Limit Requested $ Account Choice:
Individual Account Joint Account Credit Limit Increase
APPLICANT        Note: All Applicable Sections Should Be Filled out Completely. If Not processing Of Your Application May Be Delayed
Last Name First Middle
Date of Birth No. of Dependents Home Phone Own Rent Other
Current Address City State Zip Code
Employer Self Employed Yes No Work Phone
Address Position/Occupation
CO-APPLICANT or SPOUSE        Complete This Section Only If CO-Applicant or Spouse is Applying For Joint Account
Last Name First Middle
Date of Birth No. of Dependents Home Phone Own Rent Other
Current Address City State Zip Code
Employer Self Employed Yes No Work Phone
Address Position/Occupation
*You Need Not Furnish Alimony, Child Support or MaitaniceIncome Information If You Do Not Want Us To Consider It In Evaluating Your Application

CREDIT INFORMATION       Attach Additional Sheet If Necessary
Bank Name and Address
Branch Loan Open Close
Checking Account Number / Name Listed
Savings Account Number / Name Listed

Name and Address of Creditor Name Under Which Account Is Carried Account Number Balance Monthly
Payment
1. Automobile
$ $
2. Home Mortgage
$ $
3. Institution Credit Card /
Institution Name and Address
$ $
4. Other
$ $

CREDIT DISCLOSURES
ANNUAL PERCENTAGE RATE FOR PURCHASES ANNUAL MEMBERSHIP FEE GRACE PERIOD FOR PURCHASES METHOD OF COMPUTING THE BALANCE FOR PURCHASES LATE PAYMENT FEE OVER THE LIMIT FEE CASH ADVANCE FEE
12.90% NONE 25 DAYS AVERAGE DAILY BALANCE INCLUDING NEW PURCHASES $15.00 $15.00 1%
At the date this application was printed (shown in the lower right-had corner-this side) the information listed above was accurate. Because rates and terms are subject to change, you may contact us for the current information by writing to the business reply address.
A finance charge will be imposed on Credit Purchases only if you elect not to pay the entire new balance shown on your 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 your previous monthly statement within that 25-day period, a finance chare will be imposed on the unpaid average daily balance of such Credit Purchases from the previous statement closing date and on new Credit Purchases from the date of posting to your account during the current billing 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 than 25 days from the closing date. The finance charge for a billing cycle is computed by applying the monthly periodic rate to the average daily balance of Credit Purchases, which is determined by dividing the sum of the daily balances during the billing cycle by the number of days in the cycle. Each daily balance of Credit Purchases is determined by adding to the outstanding unpaid balance of Credit Purchases at the beginning of the billing cycle any new Credit Purchases posted to your account, and subtracting any payments as received or credits as posted to your account, but excluding any unpaid finance charges. A finance charge will be imposed on Cash Advances from the date made or from the first day of the billing cycle in which the Cash Advance is posted to your account, whichever is later, and will continue to accrue on the unpaid average daily balance of such Cash Advances until the date of payment if paid during the same billing cycle, or 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 than 25 days from the closing date If the new balance shown on your monthly statement for the prior billing cycle is paid in full within 25 days of the closing date of that statement, no finance charges will be imposed during the current billing cycle for Cash Advances posted to your account during previous billing cycles.

SIGNATURE(S)
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 credit policies of this institution. 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.
X__________________________________________
APPLICANT SIGNATURE      DATE
X__________________________________________
CO-APPLICANT SIGNATURE      DATE

TRANSFER OF BALANCE REQUEST
Upon approval, I wish to transfer my present balance on the credit card account(s) listed below to my new credit card account.
Visa Account No. MasterCard Account No.
Signature_____________________________ Please send a copy of your last STATEMENT.

FOR INTERNAL USE ONLY
VISA Account No.
DATE APPROVED CREDIT LINE APPROVED BY
Phone: 706-323-2721   Fax: 706-323-4589
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