Unique Approval Code:  ______ 

CARDHOLDER AGREEMENT 
NY RESIDENTS:  RETAIL INSTALMENT CREDIT AGREEMENT  

These Truth-in-Lending Act Disclosures are part of your Cardholder Agreement and contain important information about current 
rates and fees applicable to your Account.  See the remaining Agreement for additional terms and conditions governing your 
Account and for definitions of terms used herein.  Disclosures are accurate as of July 2017. 

TRUTH IN LENDING ACT DISCLOSURES 

Interest Rates and Interest Charges 

Annual Percentage Rate (APR) for 
Purchases 

XX.XX%  

Penalty APR and When they Apply 

XX.XX%  

This APR may be applied to your account if you: 
(1)  Make a late payment; or 
(2)  Make a payment that is returned. 

How Long Will the Penalty APR Apply?  If your APR is increased for any of 
these reasons, the Penalty APR will apply until you make six consecutive 
minimum payments when due. 
We will begin charging interest on the transaction date.  There is no time period 
in which to avoid paying interest.   

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 
www.consumerfinance.gov. 

Paying Interest  

For Credit Card Tips from the 
Consumer Financial Protection 
Bureau 

Fees 

<Transaction Fees> <Annual Fees> 

<None> $<X> 

Penalty Fees  
       Late Payment Fee 
        Returned Payment Fee 

Up to < Insert Late Payment Fee> 
Up to <Insert Returned Payment Fee> 

How We Will Calculate Your Balance:  We use a method called “average daily balance (including new transactions).” See the 
additional terms and conditions below for more details. 

Billing Rights:  Information on your rights to dispute transactions and how to exercise those rights is provided at the end of this 
credit agreement. 

U.S. VIRGIN ISLANDS RESIDENTS  PLEASE  READ THIS:   The provisions titled “Using Your Account,” “Security 
Interest, Postdated Checks, Restrictive Endorsements Checks and Other Disputed or Qualified Payments,” “Changes in 
Terms,”  “Assignment;Transfer,” “Arbitration Provision,” and “Billing Rights Notice,” restrict or reduce your rights. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Military  Lending  Act  Disclosure:  Federal  law  provides  important  protections  to  members  of  the  Armed  Forces  and  their 
dependents relating to extensions of consumer credit.  In general, the cost of consumer credit to a member of the Armed Forces 
and his or her dependent may not exceed an annual percentage rate of 36 percent.  This rate must include, as applicable to the 
credit transaction or account:  The costs associated with credit insurance premiums; fees for ancillary products sold in connection 
with the  credit transaction; any application fee charged (other than certain application fees for specified credit transactions or 
accounts); and any participation fee charged (other than certain participation fees for a credit card account).  To hear disclosures 
related to the Military Lending Act, please call this toll-free number:  1-866-816-6994. 

COVERED MILITARY BORROWERS:  If you are a “covered borrower,” as defined under the Military Lending Act, 10 U.S.C. 
§ 987, as amended, (i) the “Arbitration Provision,” (ii) any waiver of right to legal recourse under any state or federal law and (iii) 
any other provision in this Agreement that is not enforceable against you under the Military Lending Act does not apply to you so 
long as you are a “covered borrower.” 

GENERAL This Cardholder Agreement (“Agreement”) governs the use of your revolving credit account (your “Account”).  In this 
Agreement and in your monthly billing statement (“Statement”), “we,” “us,” “our” and “Bank” refer to Mid America Bank and Trust 
Company, member FDIC, including, as applicable, our successors, assignees and representatives.  “You,” “your” and “Cardholder” 
refer to the person who applied and was approved for the Account and, as appropriate, all persons authorized to use the Account.  
“Application” refers to any (i) written or electronic application that you signed or otherwise submitted for this Account or (ii) oral 
request for credit and a Card resulting in this Account.  “Card” refers to any credit card, Account number or other credit access 
device that we issue to you.  Your Application, any Card carrier that we send with your Card, any other written documents (including 
any  electronic  record)  evidencing  any  transactions  made  under  your  Account  and  any  notices  that  we  send  to  you  with  your 
Agreement are part of and incorporated into this Agreement.  Please read and keep these documents for your records.  This 
Agreement begins on the earlier of (a) the date we finally approve your Application for credit or (b) the first date that we extend 
credit to you or someone authorized by you on your Account.  This Agreement includes an Agreement to Arbitrate Claims 
(see “Arbitration Provision” below).    

ACCEPTANCE OF THIS AGREEMENT   Your activation of your Card, your use of the Account, or any payment made on the 
Account evidences your acceptance of the terms of this Agreement. 

USING YOUR ACCOUNT  You can use your Card to purchase or lease goods or services (including mail, telephone and electronic 
orders) from participating establishments (each a “Purchase”) up to any credit limit we may establish for you (your “Credit Limit”).  
You may use your Account only for personal, family, or household purposes.  You may not use your Card or your Account for any 
illegal  transaction  or  any  gambling  transaction.    We  may  decline  transactions  for  any  reason,  including:    operational  matters, 
default, or suspected fraudulent or unlawful activity.  Transactions above a certain dollar amount may require authorization by us 
before the transaction can be approved.  We will not be liable for the failure to authorize credit because of operational difficulties 
or mistakes.  We may limit the number and amount of transactions approved in one day for security reasons, without any liability 
to you.  We are not responsible for any losses associated with a declined transaction. 

HONORING YOUR ACCOUNT We are not liable for the failure or refusal of a participating location to honor your Account.   

PROMISE TO PAY  PROMISE TO PAY  You agree to be bound by the terms and conditions of this Agreement.  You promise to 
pay for all Purchases and all other amounts owed to us under the terms of this Agreement.  You promise to make all payments in 
U.S. dollars and to submit for payment of your Account only checks or other items drawn on U.S. financial institutions. 
YOUR CREDIT LIMIT  You agree not to use your Account in any way that would cause you to go over your Credit Limit.  We may 
refuse to authorize or accept any transaction on your Account that would cause you to exceed your Credit Limit.  We may establish 
different Credit Limits for different features of your Account in addition to a general (total) Credit Limit.  If you exceed your Credit 
Limit, you must pay us the excess amount promptly.  We reserve the right not to increase your available credit by the amount of 
any payment received, for a period of up to four (4) business days from the date of receipt to provide for processing and verification.  
Processing speeds can vary depending on how your payment is cleared.     

Your Account represents a continuing offer to extend further credit to you which may be withdrawn at any time.  We reserve the 
right to change (to set, increase, decrease or remove) the Credit Limit for your Account from time to time in accordance with this 
Agreement and applicable law.  Certain changes in your Credit Limit may occur without prior written notice to you and may be 
based upon factors including, but not limited to, anti-fraud policies and procedures, your record of making timely payments and 
staying within your established  Credit Limit,  your credit score and information contained in your credit report and your  proper 
maintenance of any checking account used to make automatic payments, if applicable. 

 
 
 
 
 
If finally approved for an Account, your initial Credit Limit(s) will appear on your Card carrier.  Your current Credit Limit(s) can be 
found on your Statement or provided upon request.  We do not accept Credit Limit increase requests. 

You have the right to receive an answer to a written inquiry concerning the status of your Account.   

SECURITY INTEREST  Except for (i) Accounts under $150, (ii) purchases by CA residents of items under $1,000; (iii) purchases 
by NY residents of any amount and (iv) purchases of clothing, software and other nondurable goods by GA residents, to secure 
your  obligations  under  this  Agreement,  you  give  us  a  purchase  money  security  interest  in  the  property  that  you  acquire  in 
connection with each Purchase made pursuant to this Agreement to the extent not prohibited by applicable law (“Collateral”) and 
all warranties and other general intangibles arising from or relating to the Collateral.  We agree that no security interest is or will 
be retained or acquired under the Agreement in any real property.  To determine our security interest in any Collateral, we will 
apply payments first to unpaid interest and other fees and charges, then to Purchases in the order in which they are posted to your 
Account  (if  more  than  one  Purchase  was  made  on  the  same  day,  your  payments  will  be  applied to  pay  off  the  lowest  priced 
Purchase first).  When payments have been made and credited to pay the price of a Purchase, the Purchase will be considered 
paid in full and our security interest will terminate, provided that all Purchases made prior to that Purchase have been paid in 
full.  We will maintain a security interest in the Collateral until that Purchase is paid in full.  You authorize us to file a financing 
statement covering the Collateral.  You agree to comply with, facilitate, and otherwise assist us in connection with perfecting our 
security interest under the Uniform Commercial Code.  You agree to sign, deliver and file any additional document or certifications 
that we may consider necessary to perfect, continue, and preserve your obligations under this Agreement and to confirm our lien 
status on any Collateral.  You will protect the Collateral and our interest in the Collateral against any competing claim.  Except as 
otherwise provided in this Agreement, you will keep the Collateral in your possession at the postal address shown in our billing 
records. You will keep the Collateral in good repair and only use the Collateral for personal, family or household purposes.  You 
will not sell, lease, license or otherwise transfer or encumber the Collateral without our prior written consent.   

SPECIAL TERMS  From time to time we may offer special terms in connection with your Account.  These special terms may be 
limited to certain qualifying transactions.  The period of time that special terms may be available may be limited.  Information 
specific to any special terms will be provided at the time of offer.  If you use your Account to enter into a qualifying transaction, you 
will be deemed to have acknowledged and agreed to the terms disclosed at the time of the offer, which terms may modify or differ 
from  the  regular  terms  of  this  Agreement.    No  formal  amendment  of  this  Agreement  will  be  necessary  and  all  terms  of  this 
Agreement will remain applicable except those inconsistent with the disclosed special terms of the offer.  If at any time you fail to 
comply with the terms of this Agreement as modified by the special terms of an offer or are otherwise in default of any obligation 
you owe us, then we may, in our sole discretion, immediately terminate any special offer terms.  We will notify you of the termination 
of any special terms if (and as) expressly required by law. 

DEFAULT  Unless prohibited by applicable law, you will be in default under this Agreement if you:  (i) do not make at least the 
Minimum Payment on or before the Payment Due Date; (ii) exceed your Credit Limit without permission; (iii) tender a check or 
money  order  in  payment  of  your  Account  and  that  payment  is  returned  to  us  unpaid  for  any  reason;  (iv) become  subject  to 
bankruptcy or insolvency proceedings; (v) become subject to attachment or garnishment proceedings; (vi) give us any misleading, 
false,  incomplete  or  incorrect  information  or  false  or  fraudulent  signature;  (vii) die;  or  (viii) fail  to  comply  with  any  term  of  this 
Agreement or any other agreement that you have with us.  Subject to any required notice of default and right to cure or other 
limitation of applicable law, if you are in default, we may, in addition to any other rights that we may have under this Agreement: 
(a) reduce your Credit Limit or cancel your Account; (b) require you to pay your entire Account balance (including accrued but 
unpaid interest and any other fees and charges provided for in this Agreement) immediately; and/or (c) bring an action to collect 
all amounts owed. 

You  agree  to  pay,  to  the  greatest  extent  not  prohibited  by  law,  our  reasonable  attorneys’  fees  and  any  collection  costs  and 
disbursements and court fees related to the collection of your Account., including, but not limited to, expenses for repossession, 
repair, storage and sale of the collateral. 

PENALTY RATE  If we do not receive your required Minimum Payment within 60 days of its Payment Due Date, all of your rates 
may increase to the appropriate Penalty Rate above.  A Penalty APR will cease to apply if we receive six consecutive minimum 
monthly payments on or before their respective payment due dates beginning with the first payment due date following the effective 
date of the increase.   

 
 
 
 
 
 
CANCELLATION  We may cancel your Account, refuse to allow further transactions, offer credit on different terms or adjust the 
amount of credit available to you at any time, with or without cause, subject to applicable limitations of law.  We may terminate 
further transactions on your Account without notice if you change your address to a jurisdiction in which we do not make credit 
available at that time.  You may close your Account by writing to us at Account Services, P.O. Box 105555, Atlanta, GA 30348-5555.  
The terms of this Agreement will continue to apply to any balance you owe us until you have paid everything you owe, including 
any charges and interest due.  Account cancellation may adversely affect your credit history. 

STATEMENTS  We will send you a Statement for each monthly billing cycle in which (i) the balance of your Account (including 
unpaid Purchases, interest and other fees and charges) on the last day of that billing cycle (the “New Balance”) is greater than $1 
(debit or credit); (ii) we impose interest or a fee; (iii) there is any other activity on your Account or (iv) as otherwise required by 
applicable law.  Your Statement will show, among other things, the total minimum payment you must make during the billing cycle 
(the “Minimum Payment”) and the date that the Minimum Payment is due (the “Payment Due Date”).  

PAYMENT REQUIREMENTS AND CREDITING  

Minimum Payment  You agree to pay at least the Minimum Payment shown on your Statement by the Payment Due Date shown 
on the Statement.  You may at any time pay off your entire balance in full or more than the Minimum Payment due without 
incurring any additional charge.  We reserve the right to change your Minimum Payment requirement from time to time.  The 
Minimum Payment due each month will be an amount equal to the greater of (a) [X]% of your highest outstanding New Balance, 
since your Account was opened or since your New Balance was zero or (b) $[XX] plus (ii) the greater of (a) any past due amount 
or (b) any amount by which your New Balance exceeds your Credit Limit.  If your New Balance is less than your Minimum Payment, 
your New Balance is due in full.  You may at any time make additional payments without penalty. 

Authorization Agreement for Automatic Payments   If you enrolled in the Automatic Payment Plan, you acknowledge and 
agree to the following: (1) You authorize us to initiate electronic funds transfers (EFTs) by debit entries drawn on the bank 
account, debit or credit card you have identified to us in your application for this Account or any other account that you identify to 
us from time to time (“Bank Account”) in the amount of your required minimum payments.  If you have a Deferred Interest Plan 
and you enroll in our Automatic Payment Plan, you will need to make one or more additional payments by mail or by 
phone to avoid interest.  See Deferred Interest Balances below  You have the right to receive notice of all electronic fund 
transfers from your  Bank Account that vary in amount, and by enrolling, you agree that your monthly statement will serve as 
your notice of the amount of your monthly payment.  You may change the amount to be deducted or withdrawn at any time.  
Your new monthly payment will be effective within 3 business days of our receipt of your instruction.  (2) We will initiate 
authorized EFTs each month on or after the Payment Due Date shown on your monthly statement.  (3) You agree that in the 
event any debit is rejected or dishonored we may reinitiate the debit card account once. (4)You have provided us with all 
necessary information for the  Bank Account that you wish us to debit and the Bank Account on which the Automated Clearing 
House (ACH) debit is authorized, is a legitimate, open and active account.  You agree to notify us promptly if this information 
changes.  (5) The origination of Automated Clearing House (ACH) transactions must comply with the provisions of U.S. law.   
(6) Once enrolled, automatic payments will continue until you notify us that you wish to terminate your enrollment in the 
Automatic Payment Plan, or until we terminate your enrollment.  You may terminate your enrollment by calling Customer Service 
at the telephone number shown on your monthly statement.  You must give any notice of termination in such a manner and 
sufficiently in advance to allow us and your financial institution a reasonable opportunity to act.  We may terminate your 
enrollment if you fail to keep your Account or your Bank Account in good standing.  Delinquency or closure of either account, for 
any reason, may result in immediate termination of your enrollment in the Automatic Payment Plan.  Also, if there are insufficient 
funds in your  Bank Account to process any payment, your enrollment in the Automatic Payment Plan may be terminated 
immediately.  (7) We are not responsible for any fees that may be charged by your depository institution as the result of your 
participation in the Automatic Payment Plan. (87) You have the right to review your accounts and to withdraw any privileges 
previously granted.  (9) Participation in the Automatic Payment Plan is not a requirement of continuing credit under your account.  
Enrollment in the Automatic Payment Plan is optional. 

Right to Stop Payment and Procedure For Doing So:  If you have scheduled monthly payments through the Automatic Payment 
Plan, you can tell us to stop any of these payments by calling Customer Service at the telephone number shown on your monthly 
statement, by sending an e-mail to cs@fortivaservicing.com or by writing to us at Customer Service--Automatic Payment Plan 
Department, P.O. Box 105555, Atlanta, GA 30348-5555.  If you send us an email or write to us, your request must reach us at 
least 5 business days before the scheduled Payment Due Date.  If you call us, we may require you to put your request in writing 
and to deliver your request to us within 14 days after you call.  We may charge you a fee for each stop payment request that you 

 
 
 
 
 
 
 
give us.  If you tell us to stop a payment at least 5 business days before the Payment Due Date and we do not stop payment, 
we will be liable for your losses or damages.  

Alternative Payment Methods  If you know that we will be unable to process a scheduled automatic payment for any reason, 
then to avoid a late payment charge, you must promptly send a certified check or money order to the “Payment Address” shown 
on the front of your monthly statement, or, if offered, you may take advantage of any pay-by-phone or on-line payment service that 
we may make available to you from time to time.  If you make an alternative payment by postal mail or by pay-by-phone or on-line 
service while you are enrolled in an Automatic Payment Plan, we may treat such payment as an additional payment and process 
your next Automatic Payment Plan payment as scheduled or may reduce your next Automatic Payment Plan payment by the 
amount of any such additional payment received 

Instructions for Mailed Payments  If you pay by check or other written instrument, all payments, except disputed amounts, must 
be mailed or delivered to us at the address for payments shown on your Statement.  Payments received at the address on the 
payment coupon by 5:00 p.m. Eastern Time, Monday through Friday (except legal holidays) will be credited to your Account as 
of the date received. Payments must be received with the payment coupon (bottom portion) of your Statement in the enclosed 
return envelope. If payments are received at any other location or without your payment coupon, crediting of those payments to 
your Account may be delayed. Payments must be made to Payment Processing, P.O. Box 790105, St. Louis, MO 63179-
0105, or any other address designated by us. 

Application of Payments  Subject to applicable law, we may apply payments first to unpaid interest and other fees and charges, 
then to Purchases in the order in which they are posted to your Account.  We may apply payments to balances under Special 
Payment Plans prior to non-promotional balances. 

Disputed Payments‒Postdated Checks, Restrictive Endorsement Checks and Other Disputed or Qualified Payments  You 
agree not to send us partial payments marked “paid in full,” “without recourse,” or similar language.  If you send such a payment, 
we may accept it without losing any of our rights under this Agreement.  All notices and written communications concerning 
postdated checks, restrictive endorsement checks (including any check or other payment instrument that indicates that 
the payment constitutes “payment in full” of the amount owed or that is tendered with other conditions or limitations or 
as full satisfaction of a disputed amount) or any other disputed, nonconforming or qualified payments, must be mailed 
or delivered to Dispute Resolution, P.O. Box 105374, Atlanta, GA 30348-5374.  We may also accept late, postdated or partial 
payments without losing any of our rights under the credit agreement governing your Account.  (A postdated check is a check 
dated later than the day it was actually presented for payment.)  We are under no obligation to hold a postdated check and we 
reserve the right to process every item presented as if dated the same date received by us or our check processor unless you give 
us adequate notice and a reasonable opportunity to act on it.  Except where such notice and opportunity is given, you may not 
hold us liable for depositing any postdated check. 

INTEREST   

Interest  When your Account has an outstanding balance, we will assess periodic interest using a monthly periodic rate of interest.  
The monthly periodic rate is determined by dividing the annual percentage rate (“APR”) by 12. The monthly periodic rate is x.xxx% 
(corresponding APR of xx.x%).  Interest will be imposed in amounts or at rates not in excess of those permitted by law.  

Balance Subject To Interest  
We figure the interest charge on your Account by applying the applicable monthly periodic rate to the “average daily balance” of 
your Account.  For each type of balance, we take the beginning balance each day, add eligible new transactions and applicable 
fees, subtract any unpaid interest or other finance charges and apply any payments or credits.  This gives us the daily balances 
for that type of balance.  Then, we add up all those daily balances for the billing cycle and divide the total by the number of days 
in the billing cycle.  This gives us the “average daily balance” for that type of balance. 

When Interest Begins To Accrue  We will begin charging interest on the transaction date.  There is no time period in which to 
avoid interest on a transaction if a balance is not subject to a special promotion. 

Deferred Interest Balances.   

If you make a purchase under a special Deferred Interest Plan promotion, we will calculate interest for each cycle as described 
above.  To avoid such interest you must pay the total purchase amount and accrued fees and charges that are subject to deferred 

 
 
 
 
 
 
 
 
 
interest  (“Promotional  Balance”)  in  full  by  the  last  day  of  the  promotional  period  as  shown  in  the  Deferred  Interest  Charge 
Calculation notice on the front of your monthly statement.  Making only minimum monthly payments during the promotional period 
will not pay off your Promotional Balance by the last day of the promotional period.  If you do not pay your Promotional Balance in 
full by such date, then the interest that has accrued from the date of purchase through and including the last day of the promotional 
period (Deferred Interest Charge) will be added to your regular Purchase balance. 

FEES 

Annual Fee You agree to pay an Annual Fee of <$Insert Annual Fee> upon account opening and annually thereafter.  We will 
impose the Annual Fee on your first monthly statement and thereafter on the anniversary date of your Account until your Account 
is terminated or cancelled, whether or not you incur any interest on the Account.  The annual Fee is not refundable, except as 
provided below or as otherwise required by applicable law. 

Unless otherwise stated, the following fees may be added to your Purchase balance:  

Late Payment Fee  If you fail to make a timely payment, you agree to pay a Late Payment Fee of up to < $Insert Late Payment 
Fee>.  For PR residents, you agree to pay the lesser of $15 or 5% of the payment due for payments that are over 15 days late.  
No Late Payment Fee will exceed the amount of the related missed payment. 

Returned Payment Fee   To the greatest extent not prohibited by law, if any payment is dishonored or returned, you agree to 
pay a Returned Payment Fee of up to <$ Insert Returned payment fee.>. No Returned Payment Fee will exceed the amount of 
the refused or returned payment.   

REFUND OF INTEREST AND FEES   We will credit all interest and fees to your Account if you close your account within 30 days 
of receiving your initial Agreement and you make no charges to your Account.  After such 30-day period, interest and fees are no 
longer avoidable or refundable and you will be responsible for paying all interest and fees charged to your Account.   

CONSENT TO RECEIVE ELECTRONIC DISCLOSURES  . If, when you applied for your Account, you agreed to receive electronic 
notices  and  disclosures  in  connection  with  your  Account  (whether  at  an  electronic  mail  address  that  you  provided  in  your 
Application, at a website that we designate or otherwise), then, to the extent not prohibited by law, we may send notices concerning 
the availability of Statements and other notices and disclosures to you at the electronic mail address that you provided in your 
Application, any updated electronic mail address that you provide to us in writing, a website that we designate or otherwise, as 
mutually agreed.  If you subsequently choose to receive notices and disclosures by postal mail rather than electronically, then you 
agree to provide us with an updated postal address in a timely manner to allow us to comply with any applicable requirements of 
law. 

MONITORING AND RECORDING  To ensure that you receive quality service, you agree that we  may record all phone calls.  
These calls, between  you and our representatives, are evaluated by supervisors.   It is our goal  to provide prompt, consistent 
assistance and deliver accurate information in a professional manner.  

COMMUNICATING WITH YOU; CONSENT TO CONTACT BY ELECTRONIC AND OTHER MEANS  We may contact you for 
any lawful reason, including for the collection of amounts owed to us and for the offering of products or services in compliance with 
our Privacy Notice in effect from time to time.  No such contact will be deemed unsolicited.  To the greatest extent not prohibited 
by applicable law, we may (i) contact you at any address or telephone number (including wireless cellular telephone or ported 
landline telephone number) that you may provide to us from time to time; (ii) use any means of communication, including, but not 
limited to, postal mail, electronic mail, telephone or other technology, to reach you; (iii) use automatic dialing and announcing 
devices which may play recorded messages; and (iv) send text messages to your telephone 

NOTICE OF CHANGES IN YOUR ELECTRONIC MAIL, TELEPHONE NUMBER OR OTHER INFORMATION  You agree to notify 
us promptly of any change in your electronic mail address, your postal address, your home telephone number, place of employment 
or other information provided in your Application or otherwise provided to us from time to time, including porting a landline telephone 
number to a cellular number or VoIP, by writing to us at Account Services, P.O. Box 105555, Atlanta, GA 30348-5555 or by calling 
us at 1-800-710-2961.  

CHANGES  IN  TERMS    We  may,  at  any  time  in  accordance  with  this  Agreement  and  subject  to  the  requirements  of 
applicable law:  (i) terminate this Agreement; (ii) terminate your right to make future Purchases; (iii) change your Credit 

 
 
 
 
 
 
 
 
 
 
Limit; or (iv) add new terms or delete or change any terms and conditions of this Agreement relating to your Account 
(including changing from a non-variable to a variable periodic rate, increasing any rate of interest, increasing or adding 
fees or charges, changing the method of computing the balance upon which interest is assessed or changing the date 
upon which interest begin to accrue).  Changes that are favorable to you may be made at any time without prior notice.  
Changes in terms may be based upon factors including, but not limited to, anti-fraud policies and procedures, your record 
of making timely payments and staying within your established Credit Limit on your Account with us, your credit score 
and information contained in your credit report and your proper maintenance of any checking account used to make your 
automatic payments, if applicable. 

When required by applicable law, we will provide you with written notice of a new or deleted term or change in terms and offer you 
the right to reject terms in the manner specified at the time of notice.  No new term or change in the terms of this Agreement will 
affect your obligation to pay all amounts owing under this Agreement. 

ASSIGNMENT; TRANSFER   We may sell, assign or transfer all or any portion of your Account and all or any portion of our rights 
under this Agreement to any other person without prior notice to you.  You may not sell, assign or transfer any of your rights under 
this Agreement. 

LOST CARDS AND UNAUTHORIZED USE  Contact us immediately if you believe your Card has been lost or stolen.  
Telephoning is the best way to minimize your possible losses.  If you believe that your Card has been lost or stolen, or that 
someone has made a Purchase on your Account without your permission, call us at 1-800-710-2961. You will not be liable for 
any such unauthorized use that occurs after you notify us.  You may, however, be liable for such unauthorized use that occurs 
before you notify us.  In any case, your liability for such unauthorized use will not exceed $50.   

CREDIT REPORTS AND INFORMATION   

Credit  Reports    You  authorize  us  to  make  or  have  made  any  credit,  employment  or  other  investigative  inquiries  we  deem 
appropriate to renew, review or collect amounts owed to us on your Account.  We also may obtain follow-up credit reports on you 
for any lawful purpose as long as you have an outstanding balance. 

Notice of Information Reporting.  We may report information about your Account to credit bureaus.  Late payments, missed 
payments or other defaults on your Account may be reflected in your credit report. 

Information Sharing  You acknowledge and agree that we may share information about you with others in accordance with our 
Privacy Notice (a copy of which we will provide to you and may be obtained from www.fortivaservicing.com as it is in effect from 
time to time).   

Notice of Inaccurate Information  If you believe that we have information about you that is inaccurate or that we have reported 
or may report to a credit reporting agency information about you that is inaccurate, please notify us of the specific information that 
you believe is inaccurate by writing to us at Account Services, P.O. Box 105555, Atlanta, GA 30348-5555. 

ARBITRATION PROVISION (AGREEMENT TO ARBITRATE CLAIMS) 

Unless you are a “covered borrower,” as defined under the Military Lending Act, 10 U.S.C.  §987, as amended, and except as 
otherwise stated below, any Claim (as defined below) will be resolved by binding arbitration pursuant to (a) this Arbitration Provision 
and (b) the Code of Procedure of the national arbitration organization to which the Claim is referred (as in effect when the Claim is 
filed).  Claims will be referred to either Judicial Arbitration and Mediation Services (“JAMS”) or the American Arbitration Association 
(“AAA”), as selected by the party electing to use arbitration.  Streamlined arbitration procedures will be used if available.  If a selection 
by us of one of these organizations is unacceptable to you, you have the right, within 30 days after you receive notice of our election, 
to select the other organization listed to serve as arbitration administrator.  For purposes of this Arbitration Provision, “Claim” means 
any claim, dispute or controversy (whether in contract, tort, or otherwise), past, present or future, (collectively, "Claims") as further 
described below.  (If for any reason a selected organization cannot, will not or ceases to serve as an arbitration administrator, you 
or we may substitute another widely recognized arbitration organization that uses a similar code of procedure and is mutually 
acceptable to the parties.)   

Right To Reject Arbitration.  You may reject this Arbitration Provision.  If you do so, neither you nor we will have the right 
to engage in arbitration.  Rejecting this Arbitration Provision will have no effect on any of the other provisions in this Agreement.  

 
 
 
 
 
 
 
 
 
To reject this Arbitration Provision, you must send us your written rejection within 60 days after we open your Account, or 60 days 
after any change in terms that affects this Arbitration Provision, to Account Services Dispute Resolution, P.O. Box 105096, Atlanta, 
GA 30348-5096; ATTN: Consumer Credit Arbitration.  In your letter, you must give us the following information: Name, Address 
and Account number.  The right to reject granted here applies solely to this Arbitration Provision, and not to any other provision of 
this Agreement, or to any other agreement with us.  In the event of a dispute over whether you have provided a timely rejection 
notice, you must provide proof of delivery.  Neither party may elect to arbitrate an individual Claim brought in small claims court (or 
your state’s equivalent court, if any).  However, if a Claim that is brought in small claims court is transferred or appealed to a 
different court, either party may elect arbitration. 

Significance of Arbitration; Limitations and Restrictions.  IF YOU OR WE CHOOSE TO RESOLVE A CLAIM BY BINDING 
ARBITRATION, NEITHER YOU NOR WE WILL HAVE THE RIGHT TO (i) HAVE A COURT OR JURY DECIDE THE CLAIM 
BEING ARBITRATED (ii) ENGAGE IN PRE-ARBITRATION DISCOVERY (THAT IS, THE RIGHT TO OBTAIN INFORMATION 
FROM  THE  OTHER  PARTY)  TO  THE  SAME  EXTENT  THAT  YOU  OR  WE  COULD  IN  COURT,  (iii) PARTICIPATE  AS  A 
REPRESENTATIVE OR MEMBER OF ANY CLASS OF CLAIMANTS IN A CLASS ACTION, IN COURT OR IN ARBITRATION, 
RELATING TO ANY CLAIM SUBJECT TO ARBITRATION OR (iv) JOIN OR CONSOLIDATE CLAIMS OTHER THAN YOUR 
OWN OR OUR OWN.  OTHER RIGHTS AVAILABLE IN COURT MAY NOT BE AVAILABLE IN ARBITRATION.  Except as set 
forth below, the arbitrator’s decision will be final and binding.  Only a court may decide the validity of items (iii) and (iv) above.  
If a court holds that items (iii) or (iv) are limited, invalid or unenforceable, then this entire Arbitration Provision will be null and void.  
You or we can appeal any such holding.  If a court holds that any other part(s) of this Arbitration Provision (other than items (iii) 
and (iv)) are invalid, then the remaining parts of this Arbitration Provision will remain in force.  An arbitrator will decide all other 
issues pertaining to arbitrability, validity, interpretation and enforceability of this Arbitration Provision.  The decision of an arbitrator 
is as enforceable as any court order and may be subject to very limited review by a court.  An arbitrator may decide a Claim upon 
the submission of documents alone, or a party may request a telephonic hearing if permitted by applicable rules.  The exchange 
of non-privileged information relevant to the Claim, between the parties, is permitted and encouraged.  Either party may submit 
relevant information, documents or exhibits to the arbitrator for consideration in deciding a Claim. 

Broad Meaning of “Claims.”  The term "Claims" in this Arbitration Provision is to be given the broadest possible meaning and 
includes (by way of example and without limitation) Claims arising from or relating to (i) the application for or issuance of your 
Account,  (ii) use,  terms,  change  in  terms  or  addition  of  terms,  closing  or  collection  of  your  Account  or  this  Agreement, 
(iii) advertisements, promotions or oral or written statements related to your Account, including any Claims regarding information 
obtained by us from, or reported by us to, credit reporting agencies or others, (iv) Claims between you and our parent corporations, 
wholly or majority owned subsidiaries, affiliates, predecessors, successors, assigns, agents, independent contractors, employees, 
officers,  directors  or  representatives  arising  from  your  Account  or  this  Agreement  and  (v) Claims  regarding  the  validity, 
enforceability or scope of this Arbitration Provision or this Agreement.   

Arbitration Procedure and Costs.  For a copy of relevant codes of procedure, to file a Claim or for other information about JAMS 
and  AAA,  write  them,  visit  their  web  site  or  call  them  at:    (i) for  JAMS,  1920 Main  Street,  Suite 300,  Irvine,  CA 92614  or 
info@jamsadr.com, http://www.jamsadr.com, 1-800-352-5267; or (ii) for AAA, 1633 Broadway, 10th Floor, New York, NY 10019 or 
websitemail@adr.org, http://www.adr.org, 1-800-778-7879.  If either party fails to submit to arbitration following a proper demand to 
do so, that party will bear the costs and expenses, including reasonable attorneys’ fees, incurred by the party compelling arbitration.  
Any physical arbitration hearing that you attend will be held in the federal judicial district where you live at the time the Claim is 
filed.  The party initiating the arbitration will pay the filing fee.  You may seek a waiver of the initial filing fee or any other fees 
incurred in arbitration.  If you seek, but do not qualify for, a waiver, we will consider any written request by you for us to pay or 
reimburse you for all or part of such fees.  Each party will pay for its respective attorneys’, experts’ and witness fees, regardless of 
which  party  prevails  in  the  arbitration.    A  party  may  recover  any  or  all  expenses  from  another  party  if  the  arbitrator,  applying 
applicable law, so determines.  Allocation of fees and costs relating to appeals in arbitration will be handled in the same manner.  
For  an  explanation  and  schedule  of 
to  an  arbitration  proceeding  with  JAMS,  please  visit  
http://www.jamsadr.com/rules-streamlined-arbitration; for AAA, visit http://www.adr.org/consumer_arbitration.  The appropriate fee 
schedule in effect from time to time is hereby incorporated by reference into this Arbitration Provision.  The cost of arbitration may 
be higher or lower than the cost of bringing your Claim in court, depending upon the nature of your Claim and how the arbitration 
proceeds.  Having more than one Claim and holding face-to-face hearings can increase the cost of arbitration.  Again, neither you 
nor we will be permitted to arbitrate claims on a class-wide (that is, on other than an individual) basis.  An arbitration proceeding 
can decide only your or our Claims.  You cannot join other parties (or consolidate Claims) except with respect to persons who use 
your Account. 

that  apply 

fees 

the 

 
 
 
 
 
 
Governing Law for Arbitration.  This Arbitration Provision is made pursuant to a transaction involving interstate commerce, and 
will be governed by the Federal Arbitration Act ("FAA"), 9 U.S.C. §§ 1 et seq., as amended, notwithstanding any other governing 
law provision in this Agreement.  The arbitrator will apply applicable substantive law consistent with the FAA and applicable statutes 
of limitations and will honor claims of privilege recognized at law.  Judgment upon any arbitration award may be entered and 
enforced, including without limitation by garnishment, attachment, foreclosure or other post-judgment remedies, in any court having 
jurisdiction.  The arbitrator’s decision will be final and binding, except for any right of appeal provided by the FAA, in which case 
any party can appeal the award to a three-arbitrator panel administered by the selected arbitration administrator.  The panel will 
reconsider de novo (that is, without deference to the ruling of the original arbitration) any aspect of the initial award requested by 
the appealing party.   

Continued Effect of Arbitration Provision.  This Arbitration Provision will continue to govern any Claims that may arise without 
regard to any termination or cancellation of your Account.  If any portion of this  Arbitration Provision (other than the provisions 
prohibiting class-wide arbitration, joinder or consolidation) is deemed invalid or unenforceable under the FAA, it will not invalidate 
the remaining portions of this Arbitration Provision.  If a conflict or  inconsistency arises between the code of procedures of the 
selected arbitration administrator and this Arbitration Provision, this Arbitration Provision will control.  

DELAY IN ENFORCEMENT  We can delay or waive enforcing any of our rights under this Agreement or under applicable law 
without losing any of those rights or any other rights.  Even if we do not enforce our rights or remedies at any one time, we may 
enforce them at a later time. 

SEVERABILITY  Except as otherwise expressly provided in the Arbitration Provision, if any provision of this Agreement is finally 
determined to be void or unenforceable under applicable law, rule or regulation, all other provisions of this Agreement shall still be 
valid and enforceable. 

ENTIRE AGREEMENT  This Agreement, including any other written, oral or electronic document incorporated into and made a 
part of this Agreement, is the entire agreement between you and us relating to your Account and supersedes any other prior or 
contemporaneous agreement between you and us relating to your Account.  Unless otherwise clearly indicated, if  there is any 
conflict between any one of these documents and this Agreement, the terms of this Agreement control.  This Agreement may not 
be amended except in accordance with the other provisions of this Agreement.  

GOVERNING LAW FOR CREDIT  This Agreement, and any claim, dispute or controversy (whether in contract, tort, or 
otherwise) at any time arising from or relating  to this Agreement, are governed by and construed in accordance with 
applicable federal law and, to the extent not preempted by federal law, the laws of  Missouri (without regard to internal 
principles of conflict of laws), except that the arbitration provision is governed by the Federal Arbitration Act, 9 U.S.C. 
§§ 1 et seq.  The legality, enforceability and interpretation of this Agreement and the amounts contracted for, charged 
and reserved under this Agreement will be governed by such laws. .  We extend credit pursuant to Section 408.145 of the 
Missouri Revised Statutes.  You agree that this loan is made, executed and delivered in Missouri and that we make all 
credit decisions, open all accounts and issue all proceeds from, impose all fees and charges in and receive all payments 
in our offices in Missouri.   

NOTICE:  ANY HOLDER OF THIS CONSUMER CREDIT CONTRACT IS SUBJECT TO ALL CLAIMS AND DEFENSES WHICH 
THE DEBTOR COULD ASSERT AGAINST THE SELLER OF THE GOODS OR SERVICES OBTAINED PURSUANT HERETO 
OR WITH THE PROCEEDS HEREOF.  RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS PAID 
BY THE DEBTOR HEREUNDER.   

YOU  ACKNOWLEDGE  THAT  YOU  HAVE  RECEIVED  (ELECTRONICALLY  OR  OTHERWISE)  AN  EXACT,  COMPLETELY 
FILLED-IN, LEGIBLE COPY OF THIS AGREEMENT, HAVE READ IT AND AGREE TO ITS TERMS.  

NOTICE TO THE BUYER  

1.  DO NOT SIGN THIS BEFORE YOU READ IT OR IF IT CONTAINS ANY BLANK SPACES.   

2.  YOU ARE ENTITLED TO AN EXACT, COMPLETELY FILLED IN COPY OF THE AGREEMENT YOU SIGN.   

3.  YOU HAVE THE RIGHT TO PAY, IN ADVANCE, THE FULL AMOUNT DUE. 

CA RESIDENTS:  Interest is compounded on unpaid amounts.  

 
 
 
 
 
 
 
 
 
MD RESIDENTS:  You have the right under Section 120510 of the commercial law code to receive an 
answer to your written inquiry regarding the status of your account. 

MO RESIDENTS:  Oral agreements or commitments to loan money, extend credit or to forbear from enforcing 
repayment of a debt including promises to extend or renew such debt are not enforceable. To protect you (borrower) 
and us (creditor) from misunderstanding or disappointment, any agreements we reach covering such matters are 
contained in this writing, which is the complete and exclusive statement of the agreement between us, except as we 
may later agree in writing to modify it. 

 NH RESIDENTS This Agreement provides for reasonable attorneys’ fees to be awarded to us in an action against you involving 
this Agreement.  Reasonable attorney's fees will be awarded to you if you prevail in any action, suit or proceeding brought by us; 
or an action brought by you.  If you successfully assert a partial defense or set-off, recoupment or counterclaim to an action 
brought by us the court may withhold from us the entire amount or such portion of the attorney fees as the court considers 
equitable. 

 NJ RESIDENTS:  Because certain provisions of this agreement are subject to applicable law, they may be void, unenforceable 
or inapplicable in some jurisdictions.  None of these provisions, however, is void, unenforceable or inapplicable in New Jersey.  

NY RESIDENTS:  RETAIL INSTALMENT CREDIT AGREEMENT  

WI RESIDENTS: No provision of a marital property agreement, a unilateral statement under section 766.59 or a court 
decree under section 786.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit 
is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision 
when the obligation to the creditor is incurred. 

BUYER/CARDHOLDER  Your name and address, our name and address and the date on any Application or any other document 
or record you sign in connection with your Account are incorporated here and made a part of this Agreement and represent your 
name and address, our name and address, and the date on this Agreement.  The electronic record of your transmission of the 
Unique Approval Code above, if applicable and consummation of a sales transaction financed under this Agreement represents 
your signature on this Agreement.   

CREDITOR  /s/ MID AMERICA BANK & TRUST COMPANY, Rolla, MO 

REV. DATE: July 2017  

BILLING RIGHTS NOTICE 

Your Billing Rights: Keep This Document For Future Use 

This notice tells you about your rights and our responsibilities under the Fair Credit Billing Act. 

What To Do If You Find A Mistake On Your Statement 

If you think there is an error on your statement, write to us at: 
Account Services Dispute Resolution  
P.O. Box 105374 
Atlanta, GA  30348-5374  
In your letter, give us the following information: 
  Account information:  Your name and account number. 
  Dollar amount:  The dollar amount of the suspected error. 
  Description of problem:  If you think there is an error on your bill, describe what you believe is wrong and why you believe 

it is a mistake. 

You must contact us: 
  Within 60 days after the error appeared on your statement. 
  At least 3 business days before an automated payment is scheduled, if you want to stop payment on the amount you 

think is wrong. 

You must notify us of any potential errors in writing.  You may call us, but if you do we are not required to investigate any 

potential errors and you may have to pay the amount in question. 
What Will Happen After We Receive Your Letter 
When we receive your letter, we must do two things: 

 
 
 
 
 
 
1.  Within 30 days of receiving your letter, we must tell you that we received your letter.  We will also tell you if we have already 

corrected the error. 

2.  Within 90 days of receiving your letter, we must either correct the error or explain to you why we believe the bill is correct. 

While we investigate whether or not there has been an error: 

The charge in question may remain on your statement, and we may continue to charge you interest on that amount. 

  We cannot try to collect the amount in question, or report you as delinquent on that amount. 
 
  While you do not have to pay the amount in question, you are responsible for the remainder of your balance. 
  We can apply any unpaid amount against your credit limit.  

After we finish our investigation, one of two things will happen: 

 

If we made a mistake:   You will not have to pay the amount in question or any interest or other fees related  to that 

amount. 

 

If we do not believe there was a mistake:  You will have to pay the amount in question, along with applicable interest and 
fees.  We will send you a statement of the amount you owe and the date payment is due.  We may then report you as delinquent 
if you do not pay the amount we think you owe. 

If you receive our explanation but still believe your bill is wrong, you must write to us within 10 days telling us that you still 
refuse to pay.  If you do so, we cannot report you as delinquent without also reporting that you are questioning your bill.  We must 
tell you the name of anyone to whom we reported you as delinquent, and we must let those organizations know when the matter 
has been settled between us. 

If we do not follow all of the rules above, you do not have to pay the first $50 of the amount you question even if your bill is 

correct. 
Your Rights If You Are Dissatisfied With Your Credit Card Purchases 

If you are dissatisfied with the goods or services that you have purchased with your credit card, and you have tried in good 

faith to correct the problem with the merchant, you may have the right not to pay the remaining amount due on the purchase. 

To use this right, all of the following must be true: 
1.  The purchase must have been made in your home state or within 100 miles of your current mailing address, and the 

purchase price must have been more than $50.  (Note: Neither of these are necessary if your purchase was based on an 
advertisement we mailed to you, or if we own the company that sold you the goods or services.) 

2.  You must have used your credit card for the purchase. Purchases made with cash advances from an ATM or with a 

check that accesses your credit card account do not qualify. 

3.  You must not yet have fully paid for the purchase. 
If all of the criteria above are met and you are still dissatisfied with the purchase, contact us in writing at: 
Account Services Dispute Resolution  
P.O. Box 105374 
Atlanta, GA  30348-5374  
While we investigate, the same rules apply to the disputed amount as discussed above. After we finish our investigation, we 

will tell you our decision.  At that point, if we think you owe an amount and you do not pay, we may report you as delinquent. 

Account Number: XXXXXXXXXXXXXXXX