CREDIT CARD APPLICATION 
                             Visit uiccu.org for a complete list of card benefits.  
      
     Which card type are you applying for (please choose one)? 
           
          ? Black & Gold MasterCard- $1,000 minimum credit line 
              Black & Gold MasterCard offers one of the lowest rates nationwide. Currently members can enjoy a variable rate as low as 6.0% APR. 
           
          ? Platinum MasterCard- $1,000 minimum credit line 
                Our Platinum MasterCard features non-variable rates starting as low as 9.9% APR.  It also features an introductory rate as low as 0% 
                APR and no balance transfer fees.  It�s an excellent choice for members who are transferring a balance and want a non-variable rate. 
           
          ? Platinum Rewards MasterCard- $5,000 minimum credit line 
               Earn points each time you use our Platinum Rewards MasterCard.  You can redeem those points for cash, travel, merchandise, event 
               tickets and much more. You�ll earn at least one point for each dollar of purchase, or considerably more if shopping with a merchant on 
               our Rewards Plus list. And don�t forget the 1,000 bonus points you get with your first purchase. Visit 
              www.selectyourrewards.com/UICCU and select �browse only� for details. 
            
          ? World MasterCard - $10,000 minimum credit line / $100,000 or greater minimum annual income required to apply 
               This card also offers reward points that you can redeem for cash, travel, merchandise, event tickets and much more. It offers a low fixed   
                rate and world class benefits including Travel Assistance, Concierge Services, Luxury Hotel benefits, and Global Service.  
                                                                                                            
     Credit line requested $____________________ (If greater than the minimum listed above.) 
       
     Applicant information (Please print clearly. All information is required to process.) 
     Are you a citizen or permanent resident of the United States?   ?Yes ?No 
     _____________________________________________  ____________________  ____________________  ____________________  
     Name  (as you wish it to appear on the card)   Date of Birth   Social Security #   Mother�s Maiden Name 
      
     _____________________________________________          ____________________             ____________________          ____________________ 
     Street Address                 How Long at Address   Home Phone   UICCU Member Number 
       
      _________________________________________________________________________  ____________________  ____________________  
      City           State          ZIP            Cell Phone     Email Address 
       
      ____________________________________________  ____________________  ____________________  Do You  ? Own  ? Rent 
      Employer                      Date Employed   Work Phone    Payment $___________ 
      
     $___________________    $______________________ 
     Gross Annual Income  Other Gross Annual Income (Alimony, child support, or separate maintenance income need not be revealed if you  
                          do not wish to have it considered as a basis for repaying the obligation). 
      
     Name:___________________________________________City/State:________________________________________Phone Number________________ 
      
     Name:___________________________________________City/State:________________________________________Phone Number________________ 
               REQUIRED:  Please list the information of the nearest relatives not living with you. 
      
     Co-applicant information (Please print clearly.) 
      
     _____________________________________________  ____________________  ____________________  ____________________  
     Name  (as you wish it to appear on the card)   Date of Birth   Social Security #   Mother�s Maiden Name 
      
     _____________________________________________          ____________________             ____________________          ____________________ 
     Street Address                 How Long at Address   Home Phone   UICCU Member Number 
       
      ____________________________________________________________________   ____________________  ____________________  
      City           State          ZIP            Cell Phone     Email Address 
       
      ____________________________________________  ____________________  ____________________  Do You  ? Own  ? Rent 
      Employer                      Date Employed   Work Phone    Payment $___________ 
       
      $___________________    $______________________ 
      Gross Annual Income  Other Gross Annual Income (Alimony, child support, or separate maintenance income need not be revealed if you  
                          do not wish to have it considered as a basis for repaying the obligation). 
     Card Type       World & Platinum Rewards   Platinum            Black & Gold 
                                Interest Rates and Interest Charges 
                                         A fixed Introductory rate of 0%-11.9%* 
     Introductory Annual 
     Percentage Rate (APR) for           shall apply for the first six months.  Thereafter, 
                    N/A                  the APR for all outstanding indebtedness and  N/A 
     Purchases, Balance Transfers 
     and Cash Advances                   new balances relating to purchase transactions 
                                         shall be at the rate listed below. 
                    11.9 � 18.9%*        9.9 � 16.9%*         6.0 � 15.0%* 
     APR for purchases, Balance  Non- Variable Rate  Non- Variable Rate  Variable Rate 
     Transfers and Cash Advances  *Your APR is dependent on your Credit  *Your APR is dependent on your Credit  *Your APR is dependent on your Credit 
                    Worthiness           Worthiness           Worthiness and will vary based on the Prime 
                                                              Rate**. 
                                          
     How to Avoid Paying Interest  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 
                                                               
     on Purchases   by the due date each month.  We will begin charging interest on cash advances and balance transfers on the transaction date. 
                                                              If you are charged interest, the charge will be 
     Minimum Finance Charge  None        None 
                                                              no less than $1.00 
     For Credit Card Tips from the 
                    To learn more about factors to consider when applying for or using a credit card, visit the website of the Consumer Financial Protection 
     Consumer Financial Protection 
                    Bureau at www.consumerfinance.gov/learnmore. 
     Bureau 
     Fees 
     Annual Fee     None                 None                 None 
                                                               
                                               
                                                                 1.  Either $5, or 3% of the amount of 
                                             
     Transaction Fees                                              each transfer, whichever is greater 
                       1.  None             1.  None 
     1.  Internal Balance Transfer                               2.  None 
                       2.  None             2.  None 
        Fees                                                     3.  Either $5, or 3% of the amount of 
                       3.  None             3.  None 
     2.  External Balance                                          each check, whichever is greater 
                       4.  Either $5, or 3% of the amount of  4.  Either $5, or 3% of the amount of 
        Transfers Fees                                           4.  Either $5, or 3% of the amount of 
                         each cash advance, whichever is  each cash advance, whichever is 
     3.  Convenience Check Fees                                    each cash advance, whichever is 
                         greater              greater 
     4.  Cash Advance Fees                                         greater 
                       5.  1% of each foreign transaction in  5.  1% of each foreign transaction in 
     5.  Foreign Transaction Fees                                5.  1% of each foreign transaction in 
                         U.S. dollars         U.S. dollars 
                                                                   U.S. dollars 
                                          
                                                               
     Penalty Fees 
                       �  Up to $15         �  Up to $15         �  Up to $15 
     �  Late Payment Fee 
                       �  None              �  None              �  None 
     �  Over-the-Credit Limit Fee 
                       �  Up to $25         �  Up to $25         �  Up to $25 
     �  Returned Check Fee 
     Other Fees & Charges  Card Replacement Fee (for any reason): $10.00 
        �  How We Will Calculate Your Interest:  We use a method called �average daily balance (including new purchases).�  See your cardholder agreement for more details. 
        �  Payments:  The minimum monthly payment is 2% of the new balance, or $25.00, whichever is greater.  If the unpaid interest and fees on the account are greater than the 
           minimum monthly payment, the minimum monthly payment will become that amount.  Any amount that is past due or prior minimum payments that were not made will also be 
           added to the minimum monthly payment amount. 
        �  Loss of Introductory APR: You will lose your Introductory APR if your account becomes delinquent or over the limit. 
        �  **Variable-rate Features:  The rate applicable to your account if the Black and Gold MasterCard is chosen will vary with the market based on the Prime Rate and may 
           increase if the Prime Rate increases.  We add 2.75%, 4.75%, 7.75% or 11.75% to the Prime Rate to determine the account APR based on credit worthiness. 
           The variable rate is adjusted at the beginning of each billing cycle as applicable; the rate adjustment is based on the prime rate published in the Wall Street Journal on the 
           10 th  of each month.  Adjustments will take effect on the second statement cycle after new prime rate is published (approximately 30-35 days).  Based on the minimum 
           payment calculation, an increase in the Prime Rate may result in additional payments on the account or an increase in your scheduled minimum periodic payment amount.  
           The current Prime Rate plus the margin is the rate reflected in your Account Opening Disclosure. 
        �  This information is accurate as of 8/15/2013. 
                                      SIGNATURE(S)  
     1. You promise that everything you have stated in this application is correct to the best of your  bureau from which it received a credit report on you. It is a federal crime to willfully and 
     knowledge. If there are any important changes you will notify us in writing immediately. You  deliberately provide incomplete or incorrect information on loan applications made to 
     authorize the UICCU to obtain credit reports in connection with this application for credit and  federal credit unions or state chartered credit unions insured by the NCUA.  
     for any update, increase, renewal, extension or collection of the credit received. You  2. You understand that the use of your card will constitute acknowledgement of receipt and 
     understand that the UICCU will rely on the information in this application and your credit report  agreement to the terms of the credit card agreement and disclosures. MasterCard may not 
     to make its decision. If you request, the UICCU will tell you the name and address of any credit   be used for any illegal transactions. 
     ?___________________              ?____________________ 
          Applicant Signature                             Date                                  Other Applicant Signature                     Date 
      
                                    FOR UICCU USE ONLY 
      Average Beacon  _________  Line-of-Credit amount approved $_____________  Is this card replacing an existing UICCU Credit Card? Y/N 
              
          Originated by Employee Number: _____________________                    Approved by Employee Number:  _____________________