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 the Credit Union unless the 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

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.  You acknowledge  and  agree  that your  pledge  does  not  apply  during  any 

periods when you are a covered borrower under the Military Lending Act. For clarity, you will not be deemed a covered borrower, and your 

pledge will apply, if: (i) you become obligated on a credit transaction or establish an account for credit when you are not a covered borrower; 

or (ii) you cease to be a covered borrower.

Security Interest Acknowledgement and Agreement

Date

Security Interest Acknowledgement and Agreement

Date

SIGNATURES

By signing or otherwise authenticating below:

You promise  that  everything  you have  stated  in  this application  is  correct  to the best  of  your  knowledge,  and  that  the above  information  is  a

complete listing of what you owe. If there are any important changes you will notify us in writing immediately. You authorize the 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.  You  understand  that  the Credit Union  will rely on the information in this application and your credit report to make its decision. If you

request, the  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.

If you are applying for a credit card, 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

CREDIT UNION USE ONLY

APPROVED

DECLINED

(Adverse Action Notice Sent)

LOAN OFFICER COMMENTS:

Credit Committee or Loan Officer Signatures

APPROVED 

SIGNATURE

LINE OF CREDIT

OTHER

LIMITS:

$

$

$

OTHER

$

DEBT RATIO/SCORE

BEFORE

AFTER

Date

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X

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X

Date

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X

Date

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Date

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X

X

1.

X

DATE

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CU LOGO 

APPLICATION AND SOLICITATION DISCLOSURE 

Interest Rates and Interest Charges 
Annual Percentage Rate (APR) for 
Purchases 

8.75%, 11.75%, or 15.75% when you open your 
account, based on your creditworthiness. This APR will vary with the 
market based on the Prime Rate. 

APR for Balance Transfers 

0.00% Introductory APR until April 30, 2019.

APR for Cash Advances 

After that your APR will be 11.75%, 15.75%, or 18.00%, based on your 
creditworthiness. This APR will vary with the market based on the 
Prime Rate. 
11.75%, 15.75%, or 18.00% when you open your account, based on 
your creditworthiness. This APR will vary with the market based on the 
Prime Rate. 

Penalty APR and When it Applies 

18.00%

This APR may be applied to your account if you:

- Make a late payment
- Make a payment that is returned

How Long Will the Penalty APR Apply? If your APRs are increased 
for these reasons, the Penalty APR will apply until you make six (6) 
consecutive minimum payments when due.

How to Avoid Paying Interest on Purchases  Your due date is at least 25 days after the close of each billing cycle. 

(Seal)

For Credit Card Tips from the Consumer 
Financial Protection Bureau 

Fees 
Transaction Fees 
- Balance Transfer Fee

- Foreign Transaction Fee
Penalty Fees 
- Late Payment Fee
- Returned Payment Fee

We will not charge you any interest on purchases if you pay your entire 
balance by the due date each month.
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. 

$5.00 or 2.00% of the amount of each balance transfer, whichever is 
greater
3.00% of each transaction in U.S. dollars

Up to $27.00
Up to $27.00

How We Will Calculate Your Balance: We use a method called “average daily balance (including new purchases).” 

Promotional Period for Introductory APR: The Introductory APR for balance transfers will apply to transactions posted 
to your account from February 1, 2018, until April 30, 2018.

Loss of Introductory APR: We may end your Introductory APR for balance transfers and apply the Penalty APR if you 
are 60 days  late in  making a payment.  If  your APRs  are increased  for  this reason, the  Penalty APR  will apply until  you 
make six (6) consecutive minimum payments when due 

Application of Penalty APR: Your APR may be increased to the disclosed Penalty APR if you are 60 days late in making 
a payment or make a payment that is returned. If your APRs are increased for this reason, the Penalty APR will apply until 
you make six (6) consecutive minimum payments when due. 

Effective Date:  
The information about the costs of the card described in this application is accurate as of April 1, 2018.
This information may have changed after that date. To find out what may have changed, contact the Credit Union. 

OTHER DISCLOSURES 

©CUNA Mutual Group 2009, 10, 12 All Rights Reserved 
Balance Transfer Fee

Late Payment Fee

Returned Payment Fee

Document Copy Fee
Emergency Card Replacement Fee
Card Replacement Fee

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$5.00 or 2.00% of the amount of each balance transfer, whichever is 
greater. The fee will be waived on all balance transfers posted at the 
SEE NEXT PAGE for more important information about your account.
non-introductory APR.
Up to $27.00 or the amount of the required minimum payment, 
whichever is less, if your payment is has not been received by the third 
calendar day of the month following the date that your payment is due.
Up to $27.00 or the amount of the required minimum payment, 
whichever is less.
$5.00
$85.00
$7.00

0%

APR*

ON ALL BALANCE TRANSFERS!

*APR = Annual Percentage Rate. Rates, terms, and conditions are subject to change and may vary based on creditworthiness. The current promotional APR is fixed at 0.00% on all balance transfers 
completed by 4/30/18. A 2.00% balance transfer fee is applicable. The promotional APR is good through the billing cycle ending 4/30/19. After this date the APR will be 11.50%, 15.50%, or 18.00%. As 
of 1/1/18 the current variable Cash Advance APR is 11.50%, 15.50%, or 18.00% and the current variable APR for purchases is 8.50%, 11.50%, or 15.50%. All APRs are based on your creditworthiness 
and will vary with the market based on the Prime Rate. Rates, terms and conditions are subject to change without notice. There is an International Transaction Fee of 3% in US dollars for all international 

transactions. Equal opportunity lender. All loans are subject to approval.

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