NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES       Hl     POSTAGE WILL BE PAID BY ADDRESSEE BUSINESS REPLY MAIL FIRST-CLASS MAIL PERMIT NO. 97 LINCOLN, NE       7 eel Tae bs TL ee BANKCARD DEPARTMENT 7000 ADAMS STREET LINCOLN, NE 68507-9904         Pinnacle Bank uilding a successful financial plan takes the right resources.   That's why we work hard to provide you with quality financial services and products. Like our convenient, flexible Visa® & Visa® Gold Credit Cards. It's accepted at thousands of locations worldwide for just about any type of purchase you can dream up, Our card comes with the personal, friendly service you've come to expect from us. So, whatever your plans, choose the credit card that gives you all the value and buying power you need to get your projects off the drawing board. Apply for yours today! = Pinnacle Bank When you use the... = Pinnacle Bank Visa® or Visa® Gold Credit Card for the purchase of goods or services, the following benefits are yours! TRAVEL ACCIDENT INSURANCE You, your spouse and dependent children up to age 19 {age 25 if a full-time student at any institute of higher learning) are automatically covered with common carrier travel accident insurance every time you travel by air, bus, train, ship, taxi, or any other common carrier anywhere in the world when you charge your entire fare to our card. This coverage is provided to you at NO EXTRA COST. Not FDIC Insured, Not Insured by any Federal Government Agency, Not a Deposit, Not Guaranteed by the Bank, May go down in value. SCORECARD® BONUS POINTS Earn Bonus Points for every net retail purchase you make with our Pinnacle Bank Credit Card! You can redeem Bonus Points for brand-name merchandise and exciting travel awards. Visit www.scorecardrewards.com and browse the current award selections. You'll be amazed at what ScoreCard® has to offer! To find out how the plan works, ask one of our friendly representatives. Your points are good for 3 years from the date earned and will expire at that time if not redeemed.   With Visa® ADVANTAGE - BASIC + Travel Reservation Service + Payment Card Registration « Bonus Travel Dividends + Quarterly Newsletter + Vision Care Discounts + Key Registration « Prescription Discounts + Auto Rental Insurance Not FDIC Insured, Not Insured by any Federal Government Agency, Not a Deposit, Not Guaranteed by the Bank, May go down in value. With Visa® Gold ADVANTAGE - COMPLETE       + Travel Reservation Service + Bonus Travel Dividends + Concierge Services « Automobite Rental Insurance + Personal Shopper + Vision Care Discounts + Prescription Discounts « Medical Assistance Services « Payment Card Registration + Quarterly Newsletter + Key Registration + Auto Rental Discount + Travel Protection - Lost Luggage Locator Service ~ Lost or Damaged Luggage Insurance - Hotel-Motel Burglary Insurance Not FDIC insured, Not Insured by any Federal Gevernment Agency, Not a Deposit, Not Guaranteed by the Bank, May go down in value.     05/12 #AAGI    CREDIT APPLICATION Check Account Choice: a Indie Account                                                                                                                                                              ieg® ' : , ae Interest Rates and Interest Charges Visa® Gold (Signature required for foint applicant} ‘see co-applicant and signat sion) ' pict z ignatures section . " i Credit Limit Requested $ 0 Credit Line Increase | Annual Percentage Rate (APR) for Purchases 1 5.99 y 1 0.99 ty | Check Card Choice Visa? © Visa" Gold Fixed Fixed : IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and monay laundering activities, Federal laws require al! financial | __ instituBons to obtain, verify an¢ record information that identifies each person who opens an Acceunt Whal this means fo you: When you open an Account, we will ask for your name, address, date of bidh, and other 15.99% 10.99% '  _ information that will allow us to identify you. We may also ask lo see your driver's license oF other identifying documents. APR for Balance Transfers : —_ Fixed Fixed ' Last Name First Middle Social Security Number 15.99% 10.99% Date of Birth No. of Dependents Home Phone Cell Phone Own Rent Ober Monthly Payment $ APR for Cash Advances : * . y Payaten Fixed Fixed i | 3 {) fo 209 08 ! @.. Current Address City State Zip Code How Long {yrs} Penalty APR and When it Applies None 8B | Halling Address (diferent from above) Gity State Zp Code How Long (yrs) Your due date is al least 25 days after the close of each billing cycle. We will not charge you i Zee Previous Address (if tess than 2 years at present address) City Stale Zip Code How Long (yrs) Paying Interest interest on retail purchases if you pay your entire balance by the due date. We will begin : ese charging interest on cash advances and/or balance transfers on the transaction date. ; wee Employer Self Employed Wok Phone How Long (yrs} : Ove es LANe + if ; Oe Minimum Interest Charge NA : “35 Address Position/Occupation Monthly Gross Income $ F : : : To learn more about factors to consider when applying for or using a credit card BS [ Namo and Address of Previous Employer (less than 2 t present empl For Credit Card Tips from the Consumer Financial | visit the web site of the Consumer Financial Protection Bureau at Pi] ogep Pimper ise en yeas akpesenenes Hose Eong fy) f , s Protection Bureau http-/www.consumerfinance.aovilearnmore. 2 | Source of Additonal Income: Income fom alimony, child support or separate Amount per Month § : : maintenance need not be revealed if itis not considered in determining creditworthiness Visa® Gold : Nearest Relative {Nol Living With You} Home Phone Relationship : } ‘ Last Name First Middle Social Security Number Annual Fee NIA N/A ; 2 28 Date of Bich No. of Dependents Home Phone Cell Phone Own Rent Other Monthly Payment $ > | Zee { } ( } o a a Transaction Fees : Oss 3} Current Address City State Zip Code How Long {yss) i | wifes : eat Previous Address (if less than 2 years at present address} City State Zip Code How Long {yrs} + Balance Transfer 2.0% of the amount transferred. : fuse : ZE | Employer Self Emplayed Work Phone How Li ; | Cfe Yes No C) ong (ys) * Cash Advances 2.0% of the amount advanced ($2.00 minimum) ; Address Position/Occupation Monthly Gross Income $ . ‘ Name and Address of Creditor Name under Which Accounts Camed : ' Foreign Transaction 4.0% of each raulti-currency transaction in U. 8. Dollars er ' ooh ; Hom MotgeyalRenl I ame under Which Account Is Carrie Account Number Balance Monthly Payment 0.80% of each single-currency transaction in U.S. Dollars : =e ' bese i; | Ose j : was | 2. Bank Name & Branch Location Penalty Fees b | Get N/A : Ht PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING: This statement is submitted fo oblain credit and [Ave certify that ali information herein is true and complete. We agree that + Late Payme nt Up to $25.00 ' ow Inquiries may be made to verify information and thal credit references or verification may be given based on inquiries from other parties. This offer is subject fo the credit policies of this institution. 4a ' 5 agree fo 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 ' BE of such terms to be conclusively presumed by the applicant's use. If you intend to apply for joint credit, the undersigned shall be jointly and severally liable for any and all credit extended from time to ae ‘ 3 time. We may report information about your account to the credit bureaus. Lale payments, missed payments, or other defaulls on your account may be reflected in your credit ceport. + Over-the-Credit-Limit None ' S , x ' “ Applicant Signature Date Co-Appiicant Signature Dale : ia - i Upon approval, | wish to Lansfer my present balance on the credit card account(s) listed below fo my new credit card account. 1 (hata » Returned Payment None 1 19 a 2 Oi Credit Card Account Number Amouat to be transferred $ 3 o fr Signature Other Fees : sul a Visa Account No. : joe 2 = if processed with a live representative. No charge if processed © | Hi ual Date Approved Credit Line Appraved 8 + Telephone Payment Fee $16.00 per occurrence i bi proved By P y through the automated system. (| 28 How We Will Calculate Your Balance: We use a method called “average daily bafance” (including new purchases). An explanation of this method is provided in your account agreement. | Pianacte Bank, Lincoln, NE 68529-9900 FOLD AND SECURE WITH TAPE FOR MAILING Application ©2009 FIS® 08/12 1 AGENT ID # 000000 All contents are accurate at the time of printing, for changes that may have been made after printing please call (800) 261-8852. Billing Rights: information on your rights to dispute transactions and how to exercise those fights Is provided in your account agreement.