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

S T

Annual 

Fee

Grace 

Period

(Days)

Q

Dollars

R

Number

O

Dollars

P

Dollars

C D

APR

Dollars

F H

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

Dollars
FR 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

Dollars Dollars (Code)* Percent

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 Dollars Percent

* 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

M N O P Q R S T U
FR 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;