Application for a
                                  Select Card Choice (only one) Check Account Choice (signature required for joint application)
   Wheatland Bank                 ?  Platinum Visa  � ? Individual Account  
                                  ?  Platinum Rewards Visa  �
                 �                                 ? Joint Account 
   Platinum Visa   Credit Card                     ? Credit Limit Increase 
                                  Credit Limit Requested $
   imPortant notiCe 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 for you:  When you open an account, 
   we will ask for your 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 documentation.
                                       aPPliCant
   Last Name                     First          Middle              Social Security #  
      
   Date of Birth   # of Dependents   Primary Phone   Own       Rent       Other   Monthly Payment  
                                                                    $
   Current Street Address        City           State     Zip       How Long (Years)  
    
   Mailing Address (if different from above)    City    State   Zip   How Long (Years)
   Previous Address (if less than 2 years at current)   City    State   Zip   How Long (Years)
   Employer                      Self Employed   Work Phone         Date Employed
                                   Yes         No
   Address                                      Position/Occupation    Monthly Gross Income
                $
   Name and Address of Previous Employer (if less than 2 years at present employer) City   State   Zip   How Long (Years)
   Additional income sources.  Income from alimony, child support or other maintenance need not be revealed if not being considered in determining creditworthiness.  Amount per Month
                                                                    $
   Nearest Relative (not living with you)       Home Phone          Relationship
   Relative�s Address            City           State     Zip       Mother�s Maiden Name
                            Co-aPPliCant  (Not required for individual account)
    Last Name                     First          Middle              Social Security #  
       
    Date of Birth   # of Dependents   Primary Phone   Own  Rent  Other   Monthly Payment  
                 $ 
    Current Street Address        City           State     Zip       How Long (Years)  
     
    Mailing Address (if different from above)    City    State   Zip   How Long (Years)
    Previous Address (if less than 2 years at current)   City    State   Zip   How Long (Years)
    Employer                      Self Employed   Work Phone         Date Employed
                                   Yes         No
    Address                                      Position/Occupation    Monthly Gross Income 
                 $
                                BalanCe transfer reQuest
    Upon approval, I wish to transfer my present balance on the credift card account(s) listed below to my new credit card account.
    Account #                     Amount to be transferred   Make Transfer Payable To  
    Account #                     Amount to be transferred   Make Transfer Payable To
                                      signatures
   Please  read  the  folloWing  Carefully  Before  signing:  This  statement  is  submitted  to  obtain  credit  and  I/we  certify  that  all  of  the  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 
   presumed by the applicant�s use.  If this is a joint application, the undersigned shall be jointly and severly liable for any and all credit extended from time to time. 
    X                                        X
    Applicant Signature           Date       Co-Applicant Signature        Date
   for internal use only                   Br #:     suBmitted By:
   Date Approved              Credit Line            Approved By
                                                    disClosure of Credit Card terms
                                                       �                        �
                                           Platinum Visa  and Platinum reWards Visa
                                    �                                   �
      feature           Platinum Visa               Platinum reWards Visa
      interest rates and interest Charges
                        0% introductory rate for 6 months. After that,  0% introductory rate for 6 months. After that, 
      annual Percentage rate
      (aPr) for Purchases and  your APR will be 9.24% to 17.24%,  your APR will be 10.24% to 18.24%, 
      Balance transfers based on your creditworthiness. This APR will vary  based on your creditworthiness. This APR will vary 
                        with the market based on the Prime Rate. with the market based on the Prime Rate.
                        19.24%.  This APR will vary with the market  20.24%.  This APR will vary with the market 
      aPr for Cash advances
                        based on the Prime Rate.    based on the Prime Rate.
                        up to 26.99%.  This APR will vary with the market based on the Prime Rate.
                        This APR may be applied to your accounts if you are more than 60 days late in making your required monthly 
      Penalty aPr and 
                        minimum payments.  This APR will vary with the market based on the Prime Rate.
      When it applies
                        how long Will the Penalty aPr apply?  If your APRs are increased for the reason above, the Penalty APR 
                        will apply until you make six (6) consecutive minimum payments when due.
      how to avoid Paying Your due date is at least 25 days after the close of each billing cycle.  We will not charge you any interest 
      interest on Purchases on purchases if you pay your entire balance by the due date each month.
      minimum interest Charge none
      for Credit Card tips from 
                        To learn more about factors to consider when applying for or using a credit card, visit the website of the 
      the Consumer financial 
                        Consumer Financial Protection Bureau at http://www.consumerfinance.gov/learnmore.
      Protection Bureau
      fees
      annual fee          none
      transaction fees
      �  Balance Transfer none
      �  Cash Advances    Either $10 or 4% of the amount of each cash advance, whichever is greater
      �  Foreign Transaction 1% of each transaction in U.S. dollars
      Penalty fees
      �  Late Payment     Up to $25 for a one time occurrence, unless one of the last six payments was late, in which case, the fee 
                          may by up to $35.  The fee will be no greater than the minimum payment imposed.
      �  Returned Payment Up to $35, but no greater than the minimum payment imposed.
     how Will We Calculate your Balance:  We use a method called �average daily balance (including new purchases).�  See your account agreement for more details.
     loss of introductory aPr:  We may end your introductory APR and apply the Penalty APR if you are more than 60 days late in making your required monthly payment.
     how Will We Calculate your rate:  After any applicable introductory rate period ends, we will establish a margin of 5.74% to 13.74% (for the Wheatland Bank Platinum 
     Visa � ) OR  6.74% to 14.74% (for the Wheatland Bank Platinum Rewards Visa � ) based on your creditworthiness, and add this margin to the Prime Rate published in the 
      Wall Street Journal to determine your APR.  Your APR and margin will be stated in your Cardholder Agreement if you open a credit card account.
      Billing rights:  Information on your rights to dispute transactions and how to exercise those rights is provided in your Cardholder Agreement.
      All Annual Percentage Rates (APRs) are based on the Prime Rate or Index Rate in effect as of the date of publication, December 2015.  This information may have 
      changed after that date.  To find out what may have changed, write us at 222 North Wall Street, Suite 308, MB 12, Spokane, WA 99201.
      We reserve the right to amend the Visa Credit Card Agreement as permitted by law.
      Balance transfers from existing Wheatland Bank loans or credit cards are not permitted.
                                     wheatlandbank.com  �  800.748.8132  �  Member FDIC  �  Equal Opportunity Lender
                                                                         REV 12/2015