FR 2572 OMB No. 3170-0001
Expiration Date: xx/xx/20xx

As of: mmddyyyy

1. Name of credit card plan: Name of contact: (Limit to 36 characters) Title of contact: 2. Availability of credit card plan (enter code): 1 Phone number of contact:
Institution Name 1 = National 2 = Regional 3 = One State 2 E-Mail of contact: 3 3
Credit Card Plan Information By State: PLEASE READ INSTRUCTIONS BEFORE COMPLETING FORM

3. National 4. Regional 5. AL 6. AK 7. AZ 8. AR 9. CA 10.CO 11.CT 12. DE 13. DC 14. FL 15.GA 16. HI 17. ID 18. IL 19. IN 20. IA 21. KS 22. KY 23. LA 24. ME 25. MD (enter 10 digits, no formatting)

* Variable rate index codes: 1 = Prime, 2 = One-month T-bill, 3 = Three-month T-bill, 4 = Six-month T-bill, 5 = One-year T-bill, 6 = Fed Funds, 7 = Cost of Funds, 8 = Federal Reserve Discount Rate, 9 = Other. 

## REPORT OF TERMS OF CREDIT CARD PLANS

This report is required by law [15 U.S.C. § 1646(b)].

Percent U Transaction Fee for Purchases Minimum Finance Charge
Percent Dollars T S Annual

Fee Grace Period (Days)

Q Dollars R Number O Dollars P Dollars

C D APR
Dollars H F Balance Range From To Balance Range

From VARIABLE RATE
Index Margin Multiple To TERMS FOR SECOND TIER

Percent Dollars L (Code)* M Percent N Dollars K Dollars

To TERMS FOR FOURTH TIER
APR Balance Range From To TERMS FOR THIRD TIER
APR Balance Range From Percent J Percent G I State APR

Percent A Dollars B Dollars E DollarsFR 2527 Page 2 of 3

26. MA 27. MI 28. MN 29. MS 30. MO 31. MT 32. NE 33. NV 34. NH 35. NJ 36. NM 37. NY 38. NC 39. ND 40.OH 41.OK 42.OR 43. PA 44. RI 45.SC 46.SD 47.TN 48.TX 49. UT 50.VT 51.VA 52.WA 53.WV 54.WI 55.WY

56.Transaction fee for cash advances: 58. Over the credit limit fee: If fee is uniform over the plan's region, identify amount: If fee is uniform over the plan's region, identify amount: Amount A. B. Amount A. B. Or if fee varies over the plan's region, identify range: Or if fee varies over the plan's region, identify range: Minimum amount C. D. Minimum amount C. D. Maximum amount E. F. Maximum amount E. F. 57. Late Payment fee: 1 If fee is uniform over the plan's region, indicate amount: 2 Amount A. B. 3 Or if fee varies over the plan's region, identify range: 4 Minimum amount C. D. 5 Maximum amount E. F. 6 Transaction Fee for Purchases Annual

Fee Grace Period
Number VARIABLE RATE

(Code)* Percent Dollars Dollars

Balance Range

K L Percent J Dollars I Dollars

H Percent G Dollars F Dollars E Percent

APR

D Dollars

To

C Dollars From

B Percent A

Dollars Percent Percent Dollars * Variable rate index codes: 1 = Prime, 2 = One-month T-bill, 3 = Three-month T-bill, 4 = Six-month T-bill, 5 = One-year T-bill, 6 = Fed Funds, 7 = Cost of Funds, 8 = Federal Reserve Discount Rate, 9 = Other. State APR Balance Range TERMS FOR SECOND TIER TERMS FOR THIRD TIER TERMS FOR FOURTH TIER Minimum Finance Charge Balance Range APR Balance Range APR Index Margin Multiple From To From To From To Dollars (Days) Dollars Percent Dollars Percent S T U M N O P Q RFR 2527 Page 3 of 3

7 59. Balance computation method (enter code): 1 = Average daily balance including new purchases; 3 = Two-cycle average daily balance including new purchases; 4 = Two-cycle average daily balance including new purchases; 6 = Previous balance; 7 = Other - please describe (limit to 752 characters).

60.Credit card plan enhancements automatically included in the credit card plan (enter an "X" next to each enhancement offered). (The reporting of this is optional): 1. rebates on purchases; 2. extension of manufacturer's warranty; 3. purchase protection/security; 4. travel accident insurance; 5. travel related discounts; 6. automobile rental insurance; 7. discounts on the purchases of goods and services 8. credit card registration; 9. reduced introductory interest rate available; (other than travel related); 10. other (do not specify).

61. Name and address to obtain credit card application (limit to 288 characters):

62.Telephone number for consumers with questions about credit card rates and terms (limit to 16 characters): A toll free number is requested if available: (enter ten digits, no formatting) 2 = Average daily balance excluding new purchases; 5 = Adjusted balance;