CREDIT CARD APPLICATION VISA     There are costs associated with the use of a credit card. Information about costs, rates and fees may be contained in disclosures provided with this application or by calling us toll-free or collect at or writing to us at the address stated on this application.   Check below to indicate the type of credit for which you are applying. Married Applicants may apply for a separate account.   Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if 1. you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI) 2. your spouse will use the account, or 3. you are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support, or separate maintenance, complete the Other section to the extent possible about the person on whose payments you are relying. Joint Credit: Each Applicant must individually complete appropriate section below. If Co-Applicant is spouse of the Applicant, mark the Co-Applicant box. Credit Card Account: [J Individual L Joint If this is an application for joint credit, Applicant and Co-Applicant each agree and acknowledge the intent to apply for joint credit (sign below):     Applicant Date   IX (Seal)|} Co-Applicant Date   X (Seal)         OO Credit Limit Requested $ If Authorized User, Name:   APPLICANT OTHER [co-ppticant [] spouse [_] GUARANTOR  [_] OTHER   NAME (Last - First - Initial) NAME (Last - First - Initial)                                           ACCOUNT NUMBER SOCIAL SECURITY NUMBER/INDIVIDUAL TAX ID NUMBER | ACCOUNT NUMBER SOCIAL SECURITY NUMBERYINDIVIDUAL TAX ID NUMBER BIRTH DATE EMAIL ADDRESS BIRTH DATE EMAIL ADDRESS HOME PHONE CELL PHONE BUSINESS PHONE/EXT. HOME PHONE CELL PHONE BUSINESS PHONE/EXT. DRIVER’S LICENSE NUMBER/STATE AGES OF DEPENDENTS DRIVER'S LICENSE NUMBER/STATE AGES OF DEPENDENTS PRESENT ADDRESS (Street — City — State — Zip) Clown CC] RENT PRESENT ADDRESS (Street — City — State — Zip) Clown CURENT LENGTH AT RESIDENCE LENGTH AT RESIDENCE PREVIOUS ADDRESS (Street — City — State — Zip) Clown [2] RENT PREVIOUS ADDRESS (Street — City — State — Zip) Clown [1 RENT LENGTH AT RESIDENCE LENGTH AT RESIDENCE MORTGAGE/RENT OWED TO MORTGAGE/RENT OWED TO MORTGAGE BALANCE MONTHLY PAYMENT INTEREST RATE MORTGAGE BALANCE MONTHLY PAYMENT INTEREST RATE %     %       COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE INA COMMUNITY PROPERTY STATE: ( marRIED LL] SEPARATED [J UNMARRIED (Single - Divorced - Widowed) COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE INA COMMUNITY PROPERTY STATE: CU married [_] SEPARATED (J UNMARRIED (Single - Divorced - Widowed)   START DATE EMPLOYMENT/INCOME START DATE EMPLOYMENT/INCOME   EMPLOYMENT STATUS oO FULL TIME Oo PART TIME EMPLOYMENT STATUS oO FULL TIME O PART TIME   NAME AND ADDRESS OF EMPLOYER NAME AND ADDRESS OF EMPLOYER   NOTICE: ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED. NOTICE: ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED.   EMPLOYMENT INCOME PER OTHER INCOME PER EMPLOYMENT INCOME PER OTHER INCOME PER   TITLE/GRADE SOURCE   TITLE/GRADE SOURCE     PREVIOUS EMPLOYER NAME AND ADDRESS IF EMPLOYED LESS THAN FIVE YEARS PREVIOUS EMPLOYER NAME AND ADDRESS IF EMPLOYED LESS THAN FIVE YEARS     STARTING DATE ENDING DATE   STARTING DATE ENDING DATE   LQANLINER. © CUNA Mutual Group 2016 All Rights Reserved 00910226-AXX00-C-1-070221 (AXX002-E)    MILITARY: IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR? CL YES O NO | MILITARY: IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR? O YES CL NO WHERE ENDING/SEPARATION DATE WHERE ENDING/SEPARATION DATE     CONSENT TO CONTACT   BY SIGNING BELOW, YOU AUTHORIZE 121 FINANCIAL CREDIT UNION TO DELIVER OR CAUSE TO BE DELIVERED TO YOU AT THE TELEPHONE NUMBERS PROVIDED ABOVE, ADVERTISING AND TELEMARKETING CALLS AND TEXT MESSAGE(S) USING AN AUTOMATIC TELEPHONE DIALING SYSTEM AND/OR AN ARTIFICIAL OR PRERECORDED VOICE. YOU ARE NOT REQUIRED TO SIGN THIS AUTHORIZATION OR ENTER INTO THIS AGREEMENT AS A CONDITION OF PURCHASING ANY PROPERTY, GOODS OR SERVICES. You may withdrawal the consent provided herein at any time by providing written notice to us at Attn: Risk Management, PO Box 40769, Jacksonville, Fl 32203, by email at ask121@121fcu.org, via phone at 904-723-6300 or by any other reasonable means.         Applicant’s Signature Date Other Signature Date               x (Seal) Xx (Seal)     By executing this application, you agree we and/or our third-party vendors (including debt collectors) may contact you by telephone or text message at any telephone number associated with your account, including wireless telephone numbers (i.e. cell phone numbers) which could result in charges to you, in order to service your account or collect any amounts owed to us, excluding any contacts for advertising and telemarketing purposes as prescribed by law. You further agree methods of contact may include use of pre-recorded or artificial voice messages, and/or use of an automatic dialing device. You may withdraw the consent to be contacted on your wireless telephone number(s) at any time by written notice to us at Attn: Risk Management, PO Box 40769, Jacksonville, FL 32203, by email to ask121@121fcu.org, via phone at (904) 723-6300 or by any other reasonable means. If you have provided a wireless telephone number(s) on or in connection with this application, you represent and agree you are the wireless subscriber or customary user with respect to the wireless telephone number(s) provided and have the authority to give this consent. Furthermore, you agree to notify us of any change to the wireless telephone number(s) for which you are providing your consent to be contacted. You agree to indemnify us and our third-party vendors, and hold us and our third-party vendors, harmless, from and against any and all losses, claims, damages, liabilities, costs of expenses (including attorney’s fees) that arise out of your breach of any of the foregoing representations and agreements. In order to help mitigate harm to you and your account, we may contact you on any telephone number associated with your account, including a wireless telephone number (i.e. cell phone number), to deliver to you any messages related to suspected or actual fraudulent activity on your account, data security breaches or identity theft following a data breach, money transfers, or any other exigent messages permitted by applicable law. These contacts will not contain any telemarketing, cross-marketing, solicitation, advertising, or debt collection message of any kind. The contacts will be concise and limited in frequency as required by law. You will have an opportunity to opt-out of such communications at the time of delivery.   STATE LAW NOTICE(S)     Notice to Nebraska Residents: A credit agreement must be in writing to be enforceable under Nebraska law. To protect you and us from any misunderstandings or disappointments, any contract, promise, undertaking, or offer to forebear repayment of money or to make any other financial accommodation in connection with this loan of money or grant or extension of credit, or any amendment of, cancellation of, waiver of, or substitution for any or all of the terms or provisions of any instrument or document executed in connection with this loan of money or grant or extension of credit, must be in writing to be effective. Notice to New York Residents: New York residents may contact the New York State Department of Financial Services to obtain a comparative listing of credit card rates, fees, and grace periods. New York State Department of Financial Services: 1-800-342-3736 or www.dfs.ny.gov. Notice to Ohio Residents: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law. Notice to Wisconsin Residents: (1) No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 766.70 will adversely affect the rights of 121 Financial Credit Union unless 121 Financial Credit Union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. (2) Please sign if you are not applying for this account or loan with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.     Signature for Wisconsin Residents Only Date     Xx (Seal)           00910226-AXX00-C-1-070221 (AXX002-E)    CREDIT CARD CONSENSUAL SECURITY INTEREST     You grant us a security interest in all individual and joint share and/or deposit accounts you have with us now and in the future to secure your credit card account. Shares and deposits in an IRA or any other account that would lose special tax treatment under state or federal law if given as security are not subject to the security interest you have given in your shares and deposits. You may withdraw these other shares unless you are in default. When you are in default, you authorize us to apply the balance in these accounts to any amounts due. For example, if you have an unpaid credit card balance, you agree we may use funds in your account(s) to pay any or all of the unpaid balance. By signing or otherwise authenticating below, you are affirmatively agreeing that you are aware that granting a security interest is a condition for the credit card and you intend to grant a security interest.                           Security Interest Acknowledgement and Agreement Date Security Interest Acknowledgement and Agreement Date x (Seal) x (Seal) SIGNATURES   By signing or otherwise authenticating below: 1. You promise that everything you have stated in this application is correct to the best of your knowledge. If there are any important changes you will notify us in writing immediately. You authorize 121 Financial Credit Union to obtain credit reports in connection with this application for credit and for any update, increase, renewal, extension, or collection of the credit received and for other accounts, products, or services we may offer you or for which you may qualify. You also authorize 121 Financial Credit Union to investigate and verify any information provided in connection with this application including current and previous employment. You understand that 121 Financial Credit Union will rely on the information in this application and your credit report to make its decision. If you request, 121 Financial Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a crime to willfully and deliberately provide incomplete or incorrect information in this application. 2. You understand that the use of your card will constitute acknowledgment of receipt and agreement to the terms of the Consumer Credit Card Agreement and Disclosure.                                           Applicant’s Signature Date Other Signature Date xX (Seal) x (Seal) CREDIT UNION USE ONLY DATE [LJ APPROVED NUMBER OF CARDS__| CREDIT LIMIT CREDIT CARD NUMBER (J DECLINED $ Signatures Date Date                 x (Seal) Xx (Seal)         00910226-AXX00-C-1-070221 (AXX002-E)121 Financial CREDIT UNION PO Box 40769 ¢ Jacksonville, FL 32203 Phone: (904) 723-6300 ¢ Toll Free: FL (800) 342-2352 www.121fcu.org APPLICATION AND SOLICITATION VISA DISCLOSURE   VISA PLATINUM/VISA PLATINUM REWARDS/VISA SIGNATURE   Interest Rates and Interest Charges   Annual Percentage Rate (APR) for Purchases Visa Platinum 8.99% , 9.99%, 10.99%, 13.75% or 15.75%, when you open your account, based on your creditworthiness. This APR will vary with the market based on the Prime Rate. Visa Rewards 11.24%, 12.24%, 13.24%, 16.24% or 17.24%, when you open your account, based on your creditworthiness. This APR will vary with the market based on the Prime Rate. Visa Signature 11.24%, 12.24%, 13.24%, 16.24% or 17.24%, when you open your account, based on your creditworthiness. This APR will vary with the market based on the Prime Rate. Visa Secured 15.74% This APR will vary with the market based on the Prime Rate.     APR for Balance Transfers   Visa Platinum 1.99% Introductory APR for 15 months from issuance of the card. After that, your APR will be 8.99% , 9.99%, 10.99%, 13.75% or 15.75%, based on your creditworthiness. This APR will vary with the market based on the Prime Rate. Visa Rewards 1.99% Introductory APR for 15 months from issuance of the card. After that, your APR will be 11.24%, 12.24%, 13.24%, 16.24% or 17.24%, based on your creditworthiness. This APR will vary with the market based on the Prime Rate. Visa Signature 1.99% Introductory APR for 15 months from issuance of the card. After that, your APR will be 11.24%, 12.24%, 13.24%, 16.24% or 17.24%, based on your creditworthiness. This APR will vary with the market based on the Prime Rate. Visa Secured 15.74% This APR will vary with the market based on the Prime Rate.   LQANLINER. © CUNA Mutual Group 2009, 10, 12, 16 All Rights Reserved SEE NEXT PAGE for more important information about your account. 00910226-MXC10-P-2-070221 (MXC102-E)    APR for Cash Advances Visa Platinum 18.00% Visa Rewards 18.00% Visa Signature 18.00% Visa Secured 18.00%   How to Avoid Paying Interest on Purchases Your due date is at least 25 days after the close of each billing cycle. We will not charge you any interest on purchases if you pay your entire balance by the due date each month.   For Credit Card Tips from the Consumer Financial Protection Bureau To learn more about factors to consider when applying for or using a credit card, visit the website of the Consumer Financial Protection Bureau at http://www.consumerfinance.gov/learnmore.   Fees   Transaction Fees - Cash Advance Fee $5.00 or 2.00% of the amount of each cash advance, whichever is greater (Maximum Fee: $500.00)       - Foreign Transaction Fee None Penalty Fees - Late Payment Fee Up to $25.00 - Returned Payment Fee Up to $25.00     How We Will Calculate Your Balance: We use a method called "average daily balance (including new purchases)." Promotional Period for Introductory APR - Visa Platinum, Visa Rewards, Visa Signature: The Introductory APR for balance transfers will apply to transactions posted to your account during the first two months following issuance of your card. Any existing balances on 121 Financial Credit Union loan or credit card accounts are not eligible for the Introductory APR for balance transfers. Effective Date: The information about the costs of the card described in this application is accurate as of: September 20, 2021 This information may have changed after that date. To find out what may have changed, contact the Credit Union. For California Borrowers, the Visa Platinum, Visa Rewards, Visa Signature and Visa Secured are secured credit cards. Credit extended under this credit card account is secured by various personal property and money including, but not limited to: (a) any goods you purchase with this account, (b) any shares you specifically pledge as collateral for this account on a separate Pledge of Shares, (c) all shares you have in any individual or joint account with the Credit Union excluding shares in an Individual Retirement Account or in any other account that would lose special tax treatment under state or federal law, and (d) collateral securing other loans you have with the Credit Union excluding dwellings. Other Fees & Disclosures: Late Payment Fee: $25.00 or the amount of the required minimum payment, whichever is less, if you are six or more days late in making a payment.   Cash Advance Fee (Finance Charge): $5.00 or 2.00% of the amount of each cash advance, whichever is greater, however, the fee will never exceed $500.00.   Returned Payment Fee: $25.00 or the amount of the required minimum payment, whichever is less.   LQANLINER. © CUNA Mutual Group 2009, 10, 12, 16 All Rights Reserved SEE NEXT PAGE for more important information about your account. 00910226-MXC10-P-2-070221 (MXC102-E)Pay-by-Phone Fee: $10.00.   Statement Copy Fee: $5.00 per page.   LQANLINER. © CUNA Mutual Group 2009, 10, 12, 16 All Rights Reserved 00910226-MXC10-P-2-070221 (MXC102-E)