Atable that includes required credit
card disclosures isprovided with this
Application. Toobtain anychange inthe
required information since itwas printed,
callusat(303) 763-2555 orwrite tousatthe
address stated onthisApplication.FCIFEDERAL CREDIT UNION
POBox 620092
Littleton, CO80162-0092
(303) 763-2555
Fax: (303) 763-2559
www.fcifcu.orgVISACredit Card Application
Check below toindicate thetypeofcredit forwhich youareapplying. Married Applicants mayapply foraseparate account.
$ PER _
SOURCE_~~ __ PER _
GROSSoIndividual Credit: Youmust complete theApplicant section about yourself andtheOthersection about yourspouse if:(1)youliveinortheproperty
pledged ascollateral islocated inacommunity property state (AK,AZ,CA,10,LA,NM,NV,TX,WA,WI); (2)your spouse willusetheaccount; or
(3)youarerelying onyour spouse's income asabasis forrepayment. Ifyouarerelying onincome from alimony, child support, orseparate
maintenance, complete theOther section totheextent possible about theperson onwhose payments youarerelying.
oJoint Credit: Each applicant must individually complete theappropriate section below. IfCo-Borrower isspouse oftheapplicant, mark the
Co-Applicant box.
Guarantor: Complete theOther section ifyouareaguarantor onanaccount/loan .
�
DRIVER'S LICENSE NUMBER /STATE DRIVER'S LICENSE NUMBER /STATE
E�MAIL ADDRESS E�MAIL ADDRESS
HOME PHONE BUSINESS PHONE! EXT. BIRTH DATE BIRTH DATE HOME PHONE BUSINESS PHONE! EXT.
( ) ( )
PRESENT ADDRESS (Street� City� State� Zip) PRESENT ADDRESS (Street� cav-Stata- Zip)
MORTGAGE/RENT OWED TO: MORTGAGE/RENT OWED TO:
INTEREST RATE
%MORTGAGE BALANCE MONTHLY PAYMENT INTEREST RATE MORTGAGE BALANCE MONTHLY PAYMENT
~$~~~~~~~$~==~==~~~~~~~~--~% $ $COMPLETE FOR JOINT CREDIT, SECURED CREDIT ORIFYOU LIVE INACOMMUNITY COMPLETE FOR JOINT CREDIT, SECURED CREDIT ORIFYOU LIVE INACOMMUNITY
PROPERTY STATE: PROPERTY STATE:
MARRIED SEPARATED MARRIED SEPARATED
Employment/Income Employment/Income
NAME AND NAME AND
ADDRESS OF.. ........... ADDRESS OF .
EMPLOYER EMPLOYER
NOTICE: ALIMONY, CHILO SUPPORT, ORSEPARATE MAINTENANCE INCOME NEED NOT BEREVEALED NOTICE: ALIMONY, CHILD SUPPORT, ORSEPARATE MAINTENANCE INCOME NEED NOT BEREVEALED
IFYOU DONOT CHOOSE TOHAVE ITCONSIDERED. IFYOU DONOT CHOOSE TOHAVE ITCONSIDERED.
EMPLOYMENT INCOME OTHER INCOME EMPLOYMENT INCOME OTHER INCOME
$ PER _
SOURCE
OHIORESIDENTS ONLY: TheOhio laws against
,!,,}~o~:icE~sIjllJdiscrimination require that allcreditors make
1-- --'credit equally available toallcreditworthy
customers, andthatcredit reporting agencies maintain separate credit
histories oneach individual upon request. The Ohio Civil Rights
Commission administers compliance withthislaw.
WISCONSIN RESIDENTS ONLY: (1)Noprovision ofanymarital property
agreement, unilateral statement under Section 766,59, orcourt decree underSection 766.70 willadversely affect therights oftheCredit Union unless the
Credit Union isfumished acopy.ot theagreement, statement ordecree, or
hasactual knowledge ofitsterms, before thecredit isgranted ortheaccount
isopened, (2)Please signifyouarenotapplying forthisaccount orloanwith
your spouse. Thecredit being applied for,ifgranted, willbeincurred inthe
interest ofthemarriage orfamily oftheundersigned,
IxSIGNATURE FOR WISCONSIN RESIDENTS ONLY DATE
Signatures
1.You promise thateverything youhave stated inthisapplication isunions insured byNCUA,
correct tothebestofyour knowledge. Ifthere areanyimportant changes 2.Youunderstand thattheuseofyour card willconstitute
youwillnotify usinwriting immediately, Youauthorize theCredit Union acknowledgment ofreceipt andagreement totheterms ofthecredit
toobtain credit reports inconnection withthisapplication forcredit and cardagreement anddisclosures. Yougrant usasecurity interest in
foranyupdate, increase, renewal, extension, orcollection ofthecredit allindividual andjointshare and/or deposit accounts youhavewith
received. Youunderstand thattheCredit Union willrelyontheinformation usnowandinthefuture tosecure yourcredit cardaccount. When you
inthisapplication andyour credit report tomake itsdecision. Ifyou areindefault, youauthorize ustoapply thebalance inthese accounts
request, theCredit Union willtellyouthename andaddress ofanycredit toanyamounts due.Shares anddeposits inanIndividual Retirement
bureau from which itreceived acredit report onyou. Itisafederal crime Account, andanyother account thatwould losespecial taxtreatment
towillfully anddeliberately provide incomplete orincorrect information onunder stateorfederal lawifgiven assecurity, arenotsubject tothe
loanapplications made tofederal credit unions orstate chartered credit security interest youhavegiven inyourshares anddeposits.
I~IX=====~(S~EAL)==:;;!,IIIIX (SEAL)
DATE APPLICANT'S SIGNATURE OTHER SIGNATURE DATEII
 u,
VISAFCI FEDERAL CREDIT UNION
POBox 620092
Littleton, CO80162-0092
(303) 763-2555
Fax: (303) 763-2559
www.fcifcu.orgVISA CLASSIC
Application and Solicitation Disclosure
""s~I)
c''i;'' 'it @
@!'!qil~ if: Int:erest Rates ancilnterest Charges
Annual Percentage Rate (APR) for11.90%Purchases
APR forCash Advances 11.90%
APR forBalance Transfers 11.90%
Penalty APR andWhen itApplies None
Minimum Interest Charge None
How toAvoid Paying Interest on Your duedateisatleast 25days after theclose ofeach billing cycle,
Purchases Wedonotcharge youinterest onpurchases ifyoupayyour entire
balance bytheduedateeach month.
ForCredit Card Tips from theFederal Tolearn more about factors toconsider when applying fororusing
Reserve Board acredit card, visittheWeb siteoftheFederal Reserve Board at
http://www.federalreserve.gov/creditcard.
FeE;'s rlf'",,,
'1"",,,",.
"! If",!'
Set-up andMaintenance Fees
�Annual Fee None
�Account Maintenance FeeonClosed None
Accounts
Transaction Fees
�Cash Advance Fee None
�Foreign Transaction Fee None
Penalty Fees
�LatePayment Fee None
�Over-the-Credit Limit Fee None
�Returned Payment Fee $15.00s
HowWeWillCalculate Your Balance. Weuseamethod called "average daily balance (including newpurchases)."
Effective Date. Theinformation about thecosts ofthecard described inthisapplication isaccurate asof
December 30,2009. This information mayhave changed after thatdate. Tofindoutwhat mayhave changed,
contact theCredit Union.
OTHER DISCLOSURES
Statement Copy Fee
Document Copy Fee
Rush Fee
Emergency Card Replacement Fee
Card Recovery Fee
PayByPhone Fee
Card Replacement Fee
PINReplacement Fee
FedEx FeeNone
$12.00
$25.00
$150.00
$65.00
$5.00
$15.00 percard
$3.00
$30.00
 Please return completed
Application totheaddress
below inastamped envelope.
CutofftheApplication and
Solicitation Disclosure
and retain foryour records.
FCIFEDERAL CREDIT UNION
POBOX 620092
LITTLETON CO80162-0092Credit Caid""'-'!!i"~
Application
FCIFEDERAL CREDIT UNION
POBox 620092
Littleton, CO80162-0092
(303) 763-2555
Fax: (303) 763-2559
www.fcifcu.org
�CUNA MUTUAL GROUP, 2009,
ALL RIGHTS RESERVED1-1V2DYAOO
CCMOOO
AXC100