credit card application         
   Credit Card Application (Cont.)                                                                 Mailing Address
                                                                                                 156 Second Street
    Co-Applicant                                                                              San Francisco, CA 94105
                                          Increase your everyday 
                                                                                                    Web Address
                                                                                                   www.patelco.org
   First Name                             Middle Initial                    Last Name spending power�with 
                                                                                                      Telephone
                                                                                                   415.442.6200
                                          no strings attached.
            
   Member Number (if any)                                                 Social Security Number Toll-Free Nationwide
                                                                                            1.800.358.8228 (outside CA)
                                          Consider a smarter credit card that allows                                   Credit
                                                                                                      Locations 
   Email Address                                                                 Driver�s License/Exp. you to shop without worry because you know  Find a Patelco branch, free CO-OP ATM,  
                                                                                       or Credit Union Shared Service Center  P NO annual fee 
                                                                                                                              Card
                                          exactly what to expect.                            www.patelco.org/locations
               /           /                                                             (            )
                                                                                                                            P  NO minimum ?nance charge 
   Date of Birth                                                                   Home Phone
                                                                                                   Online Banking     Application
                                                                                           www.patelco.org/onlinebanking    P  NO over-limit fee 
                                          There are no hidden charges, no �extra� fees, 
                                                                                                              (            )  
                                                                                                                               NO balance transfer fee
                                                                                             Call-24 Telephone Banking      P
   Current Employer/Occupation                                        Work Phone and no clever attempts to nickel and dime 
                                                                                                  1.888.766.2424
                                                                                                                            P  NO penalty rate for late payments
                                          you, whether you�re using our entry-level Visa 
               /           /                                       $                            $                    / Lost or Stolen Credit Card?
   Date of Hire                                     Monthly Income 2    Other Income 2  / Source   415.442.6200             P  Same low rate for cash advances, 
                                          Classic or Student Visa, our powerful Visa                                                                    OUTSIDE
                                                                                      1.800.543.5073 (after business hours)
    Signatures                                                                                                                 purchases, and balance transfers
                                          Gold, or our Platinum Rebate MasterCard that 
                                                                                              MAP Auto Buying Service
   SEE �PATELCO CREDIT UNION CREDIT CARD TRUTH       *                                          www.patelco.org/MAP
                                          pays you 1% back  on every purchase. 
   IN LENDING DISCLOSURES� INSERT FOR IMPORTANT                                                   1.800.757.2706
   INFORMATION ABOUT RATES, FEES, AND OTHER COSTS. 
   By signing below, I request the credit indicated, authorize you to check my credit        Credit Union Direct Lending
   and report your credit experience with me to others, and authorize you to issue any        www.cudlautosmart.com
   requested credit access device such as a credit card. I agree that the credit extended  Isn�t it good to know you can buy more and do 
   to me will be subject to the terms of the Open-End Loan Agreement contained in 
   Patelco�s Member Handbook as amended from time to time plus any supplemental                                  
   documents I receive such as Schedule 1 (loan rate sheet) or open-end loan advance          Questions or Comments?
                                          more without any strings attached?
   vouchers. In consideration for and as a condition of Patelco making credit available           Send us an email.
   to me, I agree that if I fail to make required payments, you can take funds in any 
   Patelco account in which I have an interest (unless prohibited by law or the account          patelco@patelco.org
   agreement) to recover all or part of my delinquent obligation. This consent is not a                             your money. 
   pledge by me of any account and will not affect my right to withdraw funds prior to my 
   default and your exercise of your rights under this consent.
                                                                                                                             more value. 
   X
   Signature of Applicant                                                                  Date                         smart choice. 
   X
   Signature of Co-Applicant                                                            Date
   Please include a copy of a paycheck stub or other proof of income.
   To submit this application:
   Visit a branch and give it to a Member Service Representative                           All information contained within is current and 
   OR                                                                                      accurate as of the effective date printed on 
   Fax it to 209.722.2312                                                                  the cover. All information is subject to change 
                                                                                           without notice. Please consult a Member Service 
   You can also apply by phone at 800.358.8228 or online at patelco.org/credit             Representative at any Patelco branch or contact 
                                                                                           our Telephone Service Center for the most up-to-
   1  $25 annual fee to opt-in to Patelco Points Rewards Program. *  Rebate to be paid is calculated each year on November 15 and paid shortly  date product and service information.
   2  Alimony, child support, or separate maintenance income need not be revealed if you do not wish to  thereafter in the form of a deposit to the cardholder�s Tiered Savings account.
   have it considered as a basis for repaying this obligation.               Federally insured by NCUA PCUM010-0110                     Effective January 2010
                                         Patelco Credit Card Rate Disclosure
                        Effective as of 1/1/2010; subject to change. Please call 1-800-358-8228 or visit www.patelco.org to ?nd out if information has changed. Credit Card Application
                                                                                                                   q Visa Classic  q Visa Gold
                         Platinum Rebate MasterCard          Visa Gold                Visa Classic & Student Visa
                                                                                                                   $               $
    Interest Rates and Interest Charges
                                                                                                                   Credit Line Requested ($5,000 Max) Credit Line Requested ($25,000 Max)
    Annual Percentage Rate  8.15 to 12.15% APR    9.15 to 13.15% APR            13.15 to 16.15% APR
                    based on your credit worthiness.  The APR will vary with  based on your credit worthiness.  The APR will vary  
      (APR) for Purchases                                                       based on your credit worthiness.  The APR will vary with  q MasterCard q Student Visa
                    the market based on the Prime Rate with the market based on the Prime Rate the market based on the Prime Rate    
                                                                                                                   $               $
       APR for Balance  8.15 to 12.15% APR        9.15 to 13.15% APR            13.15 to 16.15% APR 
                    based on your credit worthiness.  The APR will vary with  based on your credit worthiness.  The APR will vary   based on your credit worthiness.  The APR will vary with  Credit Line Requested ($25,000 Max) Credit Line Requested ($1,000 Max)
        Transfers
                    the market based on the Prime Rate with the market based on the Prime Rate the market based on the Prime Rate
                                                                                                                   q I want individual credit.
     APR for Cash Advances 15.15% APR             16.15% APR                    17.15% APR
                    The APR will vary with the market based on the Prime Rate The APR will vary with the market based on the Prime Rate The APR will vary with the market based on the Prime Rate q We want joint credit. Co-Applicant section must be completed 
                                                                                                                    if your spouse or another person will be jointly obligated on this 
      Penalty APR and  
                    None                          None                          None                                account. Married persons can request individual credit.
       When it Applies
                                                                                                                   q Check here if you would like to use this account as Overdraft 
                    Your due date is at least 25 days after the close of each  Your due date is at least 25 days after the close of each  Your due date is at least 25 days after the close of each  Protection on your Patelco checking account.   
                    billing cycle. We will not charge interest on purchases and  billing cycle. We will not charge interest on purchases   billing cycle. We will not charge interest on purchases and 
       How to Avoid  
                    balance transfers if you pay your entire balance by the due  and balance transfers if you pay your entire balance by   balance transfers if you pay your entire balance by the due  q Check here to opt-in to the Visa Gold Rewards Program,  
       Paying Interest
                    date each month. We will begin charging interest on cash  the due date each month. We will begin charging   date each month. We will begin charging interest on cash  Patelco Points. 1
                    advances on the transaction date interest on cash advances on the transaction date advances on the transaction date
                                                                                                                    Applicant
      Minimum Interest 
                    None                          None                          None
         Charge
                                                                                                                   First Name                             Middle Initial                    Last Name
      For Credit Card Tips  To learn more about factors to consider when applying  To learn more about factors to consider when applying  To learn more about factors to consider when applying 
      from the Federal  for or using a credit card, visit the website of the Federal  for or using a credit card, visit the website of the Federal  for or using a credit card, visit the website of the Federal  INSIDE
       Reserve Board Reserve Board at: www.federalreserve.gov/creditcard Reserve Board at: www.federalreserve.gov/creditcard Reserve Board at: www.federalreserve.gov/creditcard
                                                                                                                   Member Number (date of birth if not a member)                Social Security Number
    Fees
        Annual Fee  None                          None                          None                               Email Address                                                                 Driver�s License/Exp.
       Annual fee for  
                                                                                                                   (            )                                                                    (            )
       Patelco Points   N/A                       $25 Opt-in Required           N/A
      Rewards Program                                                                                              Home Phone                                                                   Work Phone
       Balance Transfer   Either $2.50 or 2.5% of each transaction, whichever is  Either $2.50 or 2.5% of each transaction, whichever is  Either $2.50 or 2.5% of each transaction, whichever is 
     and Cash Advance Fees greater (maximum fee: $75) greater (maximum fee: $75) greater (maximum fee: $75)
                                                                                                                   Address
                    2% of each transaction in U.S. dollars if initiated or processed  2% of each transaction in U.S. dollars if initiated or   2% of each transaction in U.S. dollars if initiated or processed 
     Foreign Transaction Fee in foreign currencies or countries (this fee is in addition to  processed in foreign currencies or countries (this fee is in  in foreign currencies or countries (this fee is in addition to 
                    other applicable fees such as cash advance fees) addition to other applicable fees such as cash advance fees) other applicable fees such as cash advance fees)
                                                                                                                   City                                                   State                        Zip
      Late Payment Fee $15 if payment is 15 or more days late $15 if payment is 15 or more days late $15 if payment is 15 or more days late
                                                                                                                   Date of Occupancy:                        Month                     Year
     Over-the-Credit Limit Fee None               None                          None
     Returned Payment Fee None                    None                          None
                                                                                                                   Current Employer                                                            Occupation
   How We Will Calculate Your Balance:  We use a method called �average daily balance (including new purchases).�  See your account agreement for more details.   
                                                                                                                               /           /                                       $                            $                    /
   Billing Rights:  Information on your rights to dispute transactions and how to exercise those rights is provided in your account agreement.  
   How We Will Calculate Your Variable APRs: We will add a �Margin� to an �Index Rate� to determine your variable interest rate.  For each billing period the Index Rate we will use will be equal to the Prime Rate reported in the Fed- Date of Hire                                     Monthly Income*   Other Income* / Source
   eral Reserve Bulletin on the ?rst day of the month preceding the month in which the rate will take effect.  The Index Rate as of 12/1/09 is 3.25 percentage points. The �Margin� for purchases and balance transfers will be 4.90 
   to 8.90 percentage points for Mastercard Platinum, 5.90 to 9.90 percentage points for Visa Gold, and 9.90 to 12.90 percentage points for Visa Classic and Student Visa, based on your credit worthiness. The �Margin� for cash 
                                                                                                                   q Own Home  q Rent  q Other    $
   advances will be 11.90 percentage points for Mastercard Platinum, 12.90 percentage points for Visa Gold, and 13.90 percentage points for Visa Classic and Student Visa.
                                                                                                                                                                            Monthly Mortgage or Rental Amount
   Changes to the APRs: APRs may adjust upon legally required notice to the cardholder.
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