G-18(G) Periodic Statement Form Page 1 of 2

XXX Bank Credit Card Account Statement

Account Number XXXX XXXX XXXX XXXX

February 21, 2007 to March 22, 2007

Summary of Account Activity

Previous Balance 

Payments 

Other Credits 

Purchases 

Balance Transfers 

Cash Advances 

Past Due Amount 

Fees Charged 

Interest Charged 

$535.07

-$450.00

-$13.45

+$529.57

+$785.00

+$318.00

+$0.00

+$69.45

+$10.89

New Balance $1,784.53

Credit limit 

Available credit 

Statement closing date 

Days in billing cycle 

$2,000.00

$215.47

3/22/2007

30

QUESTIONS? 

Call Customer Service 

lost or Stolen Credit Card 1-XXX-XXX-XXXX 

1-XXX-XXX-XXXX 

Payment Information

New Balance $1,784.53 

Minimum Payment Due $48.00 

Payment Due Date 4/20/07 (before 2:00 pm) 

Late Payment Warning: If we do not receive your 

minimum payment by the date listed above, you may have 

to pay a $35 late fee and your APRs may be increased up 

to the Penalty APR of 28.99%. 

Notice about Minimum Payments: If you make only the 

minimum payment each period, you will pay more in interest 

and it will take you longer to pay off your balance. For example, 

if you had a balance of $1,000 at an interest rate of 17% 

and always paid only the minimum required, it would take 

over 7 years to repay this balance. For an estimate of the 

time it would take to repay your actual balance making only 

minimum payments, call 1-800-XXX-XXXX.

Please send billing inquiries and correspondence to: 

PO Box XXXX, Anytown, Anystate XXXXX 

Important Changes to Your Account Terms

The following is a summary of changes that are being made to your account terms. You have the right to opt out of these 

changes. For more detailed information, please refer to the booklet enclosed with this statement. The effective date of 

these changes is 5/10/07. Note: The change to your APR for purchases described below wil not go into effect at this time 

if you are already being charged a higher Penalty APR on purchases. This change will go into effect when the Penalty APR 

no longer applies. 

Revised Terms, as of 5/10/07 

APR for Purchases 16.99% 

$32 if your balance is less than or equal to $1,000; Late Payment Fee $39 if your balance is more than $1,000 

Transactions

Reference Number 

854338203FS8OO0z5 

045148714518979874 

5884186PS0388w6YM 

0544400060zlV72Vl 

55541860705RDYD0X 

554328608008w90M0 

054830709lYMRPT4l 

564891561545KOSHD 

841517877845AKOJIO 

895848561561894KOH 

1871556189456SAMKl 

2564894185189lKDFID 

Trans Date 

2/25 

3/4 

2/22 

2/24 

2/24 

2/24 

2/24 

2/25 

2/25 

2/26 

2/26 

2/27 

Post Date Description of Transaction or Credit Amount 

Payments and Other Credits 

2/25 Pymt Thank You $450.00– 

3/5 Store #13 $13.45– 

Purchases 

2/23 Store #1 $2.05 

2/25 Store #2 $12.11 

2/25 Store #3 $4.63 

2/25 Store #4 $114.95 

2/25 Store #5 $7.35 

2/26 Store #6 $14.35 

2/26 Store #7 $40.35 

2/27 Store #8 $27.68 

2/27 Store #9 $124.76 

2/28 Store #10 $32.87 

(transactions continued on next page) 

NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION 

Page 1 of 2 

Please detach this portion and return with your payment to insure proper credit. Retain upper portion for your records. 

Account Number: XXXX XXXX XXXX XXXX 

New Balance $1,784.53 

Minimum Payment Due $48.00 

Payment Due Date 4/20/07 (before 2:00 pm) 

AMOUNT ENCLOSED: $ Please indicate address change and additional 

cardholder requests on the reverse side. 

XXX Bank 

P.O. Box XXXX 

Anytown, Anystate XXXXX

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XXX Bank Credit Card Account Statement Page 2 of 2 

Account Number XXXX XXXX XXXX XXXX 

February 21, 2007 to March 22, 2007 

Transactions (cont.)

Reference Number Trans Date Post Date Description of Transaction or Credit Amount 

Purchases (cont.) 

2564561023184102315 2/28 3/1 Store #11 $14.76 

55542818705rASD0x 3/1 3/2 Store #12 $3.76 

289189194ASDS8744 3/1 3/3 Store #13 $13.45 

178105417841045784 3/2 3/6 Store #14 $2.35 

8456152156181SDSA 3/5 3/12 Store #15 $25.00 

31289105205648AWD 3/11 3/12 Store #16 $7.34 

04518478415615ASD 3/11 3/16 Store #17 $10.56 

0547810544898718AF 3/15 3/17 Store #18 $24.50 

056489413216848OP 3/16 3/17 Store #19 $8.76 

054894561564ASDW 3/17 3/18 Store #20 $14.23 

5648974891AD98156 3/19 3/20 Store #21 $23.76 

Cash Advances 

1542202074tWWzv48 2/26 2/26 Cash Advance $121.50 

14547847586KDDL564 2/28 2/28 Cash Advance $196.50 

Balance Transfers 

4545754784KOHUIOS 2/27 3/1 Balance transfer $785.00 

Fees 

9525156489SFD4545Q 2/23 2/23 Late Fee $35.00 

56415615647OJSNDS 2/26 2/26 Cash Advance Fee *transaction Fee* $5.00 

84151564SADS8745H 2/27 2/27 Balance transfer Fee *transaction Fee* $23.55 

256489156189451516L 2/28 2/28 Cash Advance Fee *transaction Fee* $5.90 

TOTAL FEES FOR THIS PERIOD $69.45 

Interest Charged 

Interest Charge on Purchases $6.31

Interest Charge on Cash Advances $4.58

TOTAL INTEREST FOR THIS PERIOD $10.89 

2007 Totals Year-to-Date 

total fees charged in 2007 $90.14

total interest charged in 2007 $18.27

Interest Charge Calculation

Your Annual Percentage Rate (APR) is the annual interest rate on your account. 

Type of Balance Annual Percentage Rate (APR) 

Balance Subject to 

Interest Rate Interest Charge 

Purchases 14.99% (v) 

(v) = variable rate 

$512.14 $6.31 

$4.58 

$0.00 

Cash Advances 21.99% (v) $253.50 

Balance transfers 0.00% $637.50 

Fee-Inclusive APR

the Fee-Inclusive APRs in this table are the APRs that you paid this period when transaction or fixed fees are taken into 

account as well as interest. 

Type of Balance Interest Charges 

Transaction or 

Fixed Fees Fee-Inclusive APR 

Purchases $6.31 $0.00 14.99% 

Cash Advances $4.58 $10.90 58.42% 

Balance transfers $0.00 $23.55 36.00%