�CUNA Mutual Group 2016  All Rights Reserved 02207364-AXX00-C-1-072617 (AXX001-E)
CREDIT CARD
APPLICATION
There are costs associated with the use of a credit card. Information about costs, rates and fees may be contained in disclosures provided with this
application or by calling us toll-free or collect at or writing to us at the address stated on this application .
Check below to indicate the type of credit for which you are applying. Married Applicants may apply for a separate account.
Individual Credit :Youmust complete theApplicant section about yourself andtheOther section about your spouse  if
1. youliveinortheproperty pledged ascollateral islocated inacommunity property state (AK, AZ,CA,ID,LA,NM, NV,TX,WA, WI)
2. yourspouse 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.
Joint Credit :Each Applicant must individually complete appropriate section below. IfCo-Borrower isspouse ofthe Applicant, mark theCo-Applicant
box.
Credit Card Account:  Individual  Joint
If this is an application for joint credit, Applicant and Co-Applicant each agree and acknowledge the intent to apply for joint credit (sign below):
Applicant Date
X (Seal)Co-Applicant Date
X (Seal)
 Credit Limit Requested $ If Authorized User, Name:
Guarantor sComplete OTHER section  below.
APPLICANT OTHERCO-APPLICANT SPOUSE GUARANTOR OTHER
NAME (Last - First - Initial) NAME (Last - First - Initial)
ACCOUNT NUMBER SOCIAL SECURITY NUMBER ACCOUNT NUMBER SOCIAL SECURITY NUMBER
BIRTH DATE EMAIL ADDRESS BIRTH DATE EMAIL ADDRESS
HOME PHONE CELL PHONE BUSINESS PHONE/EXT. HOME PHONE CELL PHONE BUSINESS PHONE/EXT.
DRIVER�S LICENSE NUMBER/STATE MOTHER�S MAIDEN NAME DRIVER�S LICENSE NUMBER/STATE MOTHER�S MAIDEN NAME
PRESENT ADDRESS (Street � City � State � Zip) OWN RENT PRESENT ADDRESS (Street � City � State � Zip) OWN RENT
LENGTH AT RESIDENCE LENGTH AT RESIDENCE
PREVIOUS ADDRESS (Street � City � State � Zip) OWN RENT PREVIOUS ADDRESS (Street � City � State � Zip) OWN RENT
LENGTH AT RESIDENCE LENGTH AT RESIDENCE
MORTGAGE/RENT OWED TO MORTGAGE/RENT OWED TO
MORTGAGE BALANCE
$MONTHLY PAYMENT
$INTEREST RATE
%MORTGAGE BALANCE
$MONTHLY PAYMENT
$INTEREST RATE
%
COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY
PROPERTY STATE:COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY
PROPERTY STATE:
MARRIED SEPARATED UNMARRIED (Single - Divorced - Widowed) MARRIED SEPARATED UNMARRIED (Single - Divorced - Widowed)
EMPLOYMENT/INCOME START DATE EMPLOYMENT/INCOME START DATE
EMPLOYMENT STATUS FULL TIME PART TIME EMPLOYMENT STATUS FULL TIME PART TIME
NAME AND ADDRESS OF EMPLOYER NAME AND ADDRESS OF EMPLOYER
NOTICE : ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT
BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED.NOTICE : ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT
BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED.
EMPLOYMENT INCOME
$PER OTHER INCOME
$PER EMPLOYMENT INCOME
$PER OTHER INCOME
$PER
TITLE/GRADE SOURCE TITLE/GRADE SOURCE
PREVIOUS EMPLOYER NAME AND ADDRESS IF EMPLOYED LESS THAN FIVE YEARS PREVIOUS EMPLOYER NAME AND ADDRESS IF EMPLOYED LESS THAN FIVE YEARS
STARTING DATE ENDING DATE STARTING DATE ENDING DATE 02207364-AXX00-C-1-072617 (AXX001-E)MILITARY : IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR? YES  NO MILITARY : IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR? YES NO
WHERE ENDING/SEPARATION DATE WHERE ENDING/SEPARATION DATE
STATE LAW NOTICE (S)
Notice toNebraska Residents :Acredit agreement must beinwriting tobeenforceable under Nebraska law. Toprotect you and usfrom any
misunderstandings ordisappointments, anycontract, promise, undertaking, oroffer toforebear repayment ofmoney ortomake anyother financial
accommodation inconnection with thisloan ofmoney orgrant orextension ofcredit, oranyamendment of,cancellation of,waiver of,orsubstitution for
anyoralloftheterms orprovisions ofanyinstrument ordocument executed inconnection with thisloan ofmoney orgrant orextension ofcredit, must
be in writing to be effective.
Notice toNew York Residents :New York residents may contact theNew York State Department ofFinancial Services toobtain acomparative listing
of credit card rates, fees, and grace periods. New York State Department of Financial Services: 1-800- 342-3736 or www.dfs.ny.gov .
Notice toOhio Residents :The Ohio laws against discrimination require thatallcreditors make credit equally available toallcreditworthy customers,
andthatcredit reporting agencies maintain separate credit histories oneach individual upon request. The Ohio Civil Rights Commission administers
compliance with this law.
Notice toWisconsin Residents :(1)Noprovision ofanymarital property agreement, unilateral statement under Section 766.59, orcourt decree under
Section 766.70 willadversely affect therights oftheCredit Union unless theCredit Union isfurnished acopy oftheagreement, statement ordecree, or
hasactual knowledge ofitsterms, before thecredit isgranted ortheaccount isopened. (2)Please sign ifyouarenotapplying forthisaccount orloan
with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.
Signature for Wisconsin Residents Only Date
X (Seal)
CONSENSUAL SECURITY INTEREST
You grant usasecurity interest inallindividual and joint share and/or deposit accounts you have with usnow and inthefuture tosecure
your credit card account. Shares anddeposits inanIRAoranyother account that would lose special taxtreatment under state orfederal law
ifgiven assecurity arenotsubject tothesecurity interest youhave given inyour shares anddeposits. You may withdraw these other shares
unless youareindefault. When youareindefault, youauthorize ustoapply thebalance inthese accounts toanyamounts due. Forexample,
if you have an unpaid credit card balance, you agree we may use funds in your account(s) to pay any or all of the unpaid balance.
Bysigning orotherwise authenticating below, youareaffirmatively agreeing that youareaware thatgranting asecurity interest isacondition
forthecredit card and you intend togrant asecurity interest .You acknowledge and agree that your pledge does notapply during any
periods when you areacovered borrower under theMilitary Lending Act. Forclarity, you willnotbedeemed acovered borrower, and your
pledge willapply, if:(i)youbecome obligated onacredit transaction orestablish anaccount forcredit when youarenotacovered borrower;
or (ii) you cease to be a covered borrower .
Security Interest Acknowledgement and Agreement Date
X (Seal)Security Interest Acknowledgement and Agreement Date
X (Seal)
SIGNATURES
By signing or otherwise authenticating below:
1. Youpromise thateverything youhave stated inthisapplication iscorrect tothebest ofyour knowledge .Ifthere areanyimportant changes youwill
notify usinwriting immediately. You authorize theCredit Union toobtain credit reports inconnection with thisapplication forcredit andforany
update, increase, renewal,extension,orcollectionofthecreditreceived.YouunderstandthattheCredit Union willrelyontheinformation inthis
application andyour credit report tomake itsdecision. Ifyourequest, theCredit Union willtellyouthename andaddress ofanycredit bureau from
which it received a credit report on you. It is a crime to willfully and deliberately provide incomplete or incorrect information in this application.
2. You understand that theuseofyour card willconstitute acknowledgment ofreceipt and agreement totheterms oftheConsumer Credit Card
Agreement and Disclosure.
Applicant�s Signature Date
X (Seal)Other Signature Date
X (Seal) �CUNA Mutual Group 2009, 10, 12, 16  All Rights Reserved 02207364-MXC10-P-1-072617 (MXC101-E)
APPLICATION AND
SOLICITATION
DISCLOSURE
Interest Rates and Interest Charges
Annual Percentage Rate (APR) for
PurchasesVisa Classic and Visa Secured
This APR will vary  with the market based on the Prime Rate .
Visa Platinum
This APR will vary  with the market based on the Prime Rate .
APR for Balance Transfers Visa Classic and Visa Secured
This APR will vary  with the market based on the Prime Rate .
Visa Platinum
This APR will vary  with the market based on the Prime Rate .
APR for Cash Advances Visa Classic and Visa Secured
This APR will vary  with the market based on the Prime Rate .
Visa Platinum
This APR will vary  with the market based on the Prime Rate .
How to Avoid Paying Interest on
PurchasesYour 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 by
the due date each month.
For Credit Card Tips from the
Consumer Financial Protection BureauTo learn more about factors to consider when applying for or using a
credit card, visit the website of the Consumer Financial Protection
Bureau at http://www.consumerfinance.gov/learnmore.
Fees
Transaction Fees
-Foreign Transaction Fee 1.00%  of each transaction in U.S. dollars
Penalty Fees
- Late Payment Fee Up to $25.00
- Over-the-Credit Limit Fee None
- Returned Payment Fee Up to $25.00
How We Will Calculate Your Balance:
We use a method called "average daily balance (including new purchases)."
SEE NEXT PAGE for more important information about your account. �CUNA Mutual Group 2009, 10, 12, 16  All Rights Reserved 02207364-MXC10-P-1-072617 (MXC101-E)Effective Date:
The information about the costs of the card described in this application is accurate as of :
This information may have changed after that date. To find out what may have changed, contact the Credit Union.
ForCalifornia Borrowers, theVisa Classic and Visa Secured and Visa Platinum aresecured credit cards. Credit
extended under this credit card account issecured byvarious personal property and money including, butnot
limited to:(a)anygoods you purchase with this account, (b)anyshares you specifically pledge ascollateral for
this account onaseparate Pledge ofShares, (c)allshares you have inany individual orjoint account with the
Credit Union excluding shares inanIndividual Retirement Account orinany other account that would lose
special taxtreatment under state orfederal law, and (d)collateral securing other loans you have with theCredit
Union excluding dwellings. Notwithstanding theforegoing, you acknowledge and agree that during any periods
whenyou areacovered borrower under theMilitary Lending Actyour credit card willbesecured byanyspecific
Pledge ofShares you grant usbutwillnotbesecured byallshares you have inany individual orjoint account
with theCredit Union. Forclarity, you willnotbedeemed acovered borrower if:(i)you establish your credit card
account when you are not a covered borrower; or (ii) you cease to be a covered borrower.
Other Fees & Disclosures:
Late Payment Fee :
$25.00 ortheamount oftherequired minimum payment, whichever isless, ifyouareoneormore days lateinmaking a
payment.
Returned Payment Fee :
$25.00 or the amount of the required minimum payment, whichever is less.
Card Replacement Fee :
$10.00 .
Document Copy Fee :
None .
Rush Fee :
$30.00 .
Statement Copy Fee :
$5.00 .