Invoice No:   ____________________________________________________________ 

SELLER:  CONN APPLIANCES, INC. d/b/a CONN’S 

Salesperson:   ___________________________________________________________ 

APPLICANT INFORMATION 

 FIRST NAME 

 INITIAL 

 LAST NAME 

APPLICATION FOR RETAIL CHARGE ACCOUNT 

 STREET ADDRESS 

 CITY  

 STATE 

 ZIP 

 HOME PHONE 

RETAIL CHARGE AGREEMENT 

ACCOUNT:  In consideration of the granting of credit on this account by Conn’s, you (meaning each person signing this account as Buyer) promise to pay us (Conn’s), the 
purchase price for purchases made on this account from time to time and any finance charges due under the terms of this Agreement.   

FINANCE CHARGE:  The FINANCE CHARGE will be computed on the balance subject to finance charge, at a monthly periodic rate not to exceed 1.75%, 
which corresponds to an ANNUAL PERCENTAGE RATE of 21.0%.   

BALANCE SUBJECT TO FINANCE CHARGE:  The balance subject to finance charge is the average daily balance, which is arrived at by adding the daily 
balances in the account during the billing period, and dividing this total by the number of days in the period.  The daily balances are determined by taking the beginning balance 
each day during the billing period and adding any new purchases and subtracting any payments and credits on the account that day. 

GRACE PERIOD:  Since new purchases are not added in determining the daily balances during billing periods when the account balance at the opening of the period is $0 
or when the account balance at the opening of the period is fully paid during the period, purchases made in these periods will not begin to accrue a finance charge until the start of 
the following period.  You will not incur a finance charge on such purchases if they are paid on or before the next billing date.  All other purchases will incur a finance charge from 
the date you receive the merchandise or services purchased. 

MINIMUM MONTHLY PAYMENTS:  You agree to pay a minimum monthly payment in an amount (rounded to the next higher dollar), which is the larger of: (1) 
1/30 of the highest balance of your account since it last had a $0 balance; or (2) $15.  Except as stated the amount of your minimum monthly payment will remain the same.  You 
may at any time pay your entire balance in full or more than the minimum monthly payment.   

DELINQUENCY CHARGE:  In addition to the continued accrual of FINANCE CHARGES at the daily rate, if you fail to pay at least the minimum monthly 
payment on your account within 10 days of the date when it is due, you may be assessed a delinquency charge which is the lesser of (1) the amount of the minimum monthly 
payment due, or (2) $22.50.  Only one such delinquency charge will be assessed on each delinquent installment. 

RETURNED PAYMENT CHARGE:  If you make a payment that is not honored by your financial institution, we may charge you a returned payment charge which is 
the lesser of (1) the amount of the minimum monthly payment due, or (2) $25.00.  This returned payment charge may be added to the unpaid balance on your account. 

Summary of Interest Rates, Fees and Charges: 

Interest Rates and Interest Charges 
Annual Percentage Rate (APR) for Purchases 

How to Avoid Paying Interest on Purchases 

Minimum Interest Charge 
For Credit Card Tips from the Federal Reserve Board 

Fees 
Penalty Fees 
      Late payment fee 
      Returned payment fee 

21.0% 
Your due date is at least 30 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. 
If you are charged interest, the charge will be no less than $0.50 
To learn more about factors to consider when applying for or using a credit card, visit the 
website of the Federal Reserve Board at:  http://www.federalreserve.gov/creditcard 

The amount of the minimum monthly payment due or $22.50, whichever is less 
The amount of the minimum monthly payment due or $25.00, whichever is less 

How We Will Calculate Your Balance:  We use a method called “average daily balance (including new purchases)”. 

PROMOTIONAL OFFERS: We may from time to time offer special promotions under which you may purchase particular goods from us on credit without being subject 
to Finance Charges for specific periods, or at lower Finance Charge rates, or with extended repayment terms. We will advise you of these special promotions when they apply, and 
will provide you with supplemental disclosures as may be required by law. 

THE INFORMATION ABOUT THE COSTS OF THE CARD DESCRIBED IN THIS AGREEMENT IS ACCURATE AS OF SEPTEMBER 10, 2010.  THIS 
INFORMATION MAY HAVE CHANGED AFTER THAT DATE.  TO FIND OUT WHAT MAY HAVE CHANGED, WRITE TO US AT CONN’S, P.O. BOX 2358, 
BEAUMONT, TEXAS 77704. 

SECURITY INTEREST:  We will have a security interest in all merchandise purchased on your account until such merchandise is paid in full.  If you do not make your 
minimum monthly payments on time, we may repossess only the merchandise which has not been paid in full. 

APPLICATION OF PAYMENTS:  Payments except down payments, shall be applied first to the unpaid finance charge, second to unpaid insurance charges, third to 
any other unpaid charges, and then to the payment of the unpaid balance of each item of merchandise in the order of its purchase.  Down payments will be credited in full to the 
items to which they apply. 

AMENDMENTS:  You agree that we may change the rates, charges and other terms of this Agreement to the extent allowed by law, provided you are given proper written 
notice and the right to opt out of the changes, if applicable. 

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DEFAULT:  If you fail to pay at least the Minimum Payment Due by the Payment Due Date indicated on your Account Statement, or if you fail to keep your promises 
or perform your obligations under this Agreement, or you become insolvent or file for bankruptcy, we have the right to declare your Account to be in default, and then 
to insist that you immediately pay us in full all amounts that you owe us then.  Your unpaid Account balance, including any returned payment fees, will continue to be 
subject to Finance Charges until you pay us in full.  If your Account is referred for collection to an attorney who is not our salaried employee, you agree to pay the 
attorney’s fees to the extent permitted by Oklahoma law.  We also reserve our rights to any other remedies we may have, such as the right to repossess and resell the 
merchandise you bought on your Account, and if the amount we get from the resale does not cover your debt to us, you agree to pay us the difference, unless that is not 
permitted by law. 

CANCELLATION:  You and we have the right to cancel this Agreement as it relates to future purchases. 

CREDIT CAPACITY AND LIMIT:  You give us the right to investigate your credit capacity and credit history.  You agree that your outstanding balance on this 
account will not exceed your credit limit.  In addition, you agree that we may change your credit capacity.  You hereby authorize us to furnish information about the account and 
yourself to credit reporting agencies and others who may lawfully receive the information.   

CREDIT APPROVAL:  This account and all purchases made on it are not binding on us until your credit is approved.  This Agreement will be considered approved when 
we give notice of approval to you. 

ARBITRATION: You agree that any claim, dispute or controversy arising from or relating to this Agreement, including the scope and validity of this arbitration clause or 
the enforcement or interpretation of any other provision of this Agreement,  shall be resolved by binding arbitration administered by the American Arbitration Association under its 
Consumer Arbitration Rules.  The claim or dispute will be arbitrated by a single arbitrator on an individual basis and not as a class action. You expressly waive any right you may 
have to arbitrate a class action. Any arbitration hearing that is held will take place at a location convenient to your residence. This arbitration clause is made pursuant to a 
transaction involving interstate commerce and shall be governed by the Federal Arbitration Act (9 U.S.C. §§ 1-16), and not by any state law that might otherwise apply.   Judgment 
upon the award may be entered in any court of law, but any said judgment shall exclude, and neither you nor we shall be entitled to, damages for any consequential, indirect, 
special or punitive damages, or damages arising from lost or prospective profits, whether known or unknown to either you or to us.  You also understand that under this arbitration 
clause, you will give up your right to participate a s a class representative or class member on any class action claim you may have against us, including any right to class 
arbitration or any consolidation of individual arbitrations.  You and we are waiving the right or opportunity to litigate disputes in a court of law.  This arbitration clause does 
not apply to any collection effort on the Account, nor shall it be construed to prevent either party’s use of bankruptcy, replevin, sequestration, seizure, reclamation or any other 
prejudgment or provisional remedy relating to any collateral, security or property interests for contractual debts now or hereafter owed by you under this Agreement.   This 
arbitration clause shall survive the termination, payoff or transfer of this Agreement.  If any part of this arbitration clause, other than the waiver of class action rights, is found by a 
court to be unenforceable for any reason, the remainder of this clause shall remain enforceable.  If the waiver of class action rights is found by a court or arbitrator to be 
unenforceable, then the whole of this arbitration clause shall be invalid and unenforceable. 

ANY HOLDER OF THIS CONSUMER CREDIT CONTRACT IS SUBJECT TO ALL CLAIMS AND DEFENSES WHICH THE 
DEBTOR COULD ASSERT AGAINST THE SELLER OF 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. 

NOTICE 

I (WE) HAVE RECEIVED A TRUE COPY OF THIS AGREEMENT HAVE READ IT AND AGREED TO ITS TERMS. 

__________________________________________________________________________________ 
Buyers Signature 

Date 

__________________________________________________________________________________ 
Buyers Signature 

Date 

SOLD, ASSIGNED, AND TRANSFERRED TO 
 CONN CREDIT I, LP by CONN APPLIANCES, INC. dba CONN’S 

Authorized Signature of Conn Appliances, Inc. 
3295 College Street 
Beaumont, Texas 77701 

All of Conn’s rights under this Agreement also apply to any assignee or holder of this Agreement.   

This instrument is assigned as collateral to Bank of Amercia, N.A. 

INSURANCE OPTIONS:  Although insurance is not required under this retail charge Agreement, we will provide for you (also referred to as “Accountholder”) Chargegard Plus, 
a combined insurance coverage, if you elect and qualify for such insurance.  Features and cost of this coverage are as follows: 

* SUMMARY OF OPTIONAL INSURANCE COVERAGES 

IMPORTANT INFORMATION ON CHARGEGARD LIMITATIONS, EXCLUSIONS, COSTS: Upon acceptance of your enrollment, 
you  will receive  your certificates and/or policies indicating  your effective date. Eligibility, restrictions and exclusions  vary by coverage and 
state. Read your certificates and/or policies carefully for full details. If you have other insurance that covers the same risks as described, you 
may not need or want to purchase this insurance. This credit insurance is optional. You are not required to purchase the insurance to obtain 
credit.  You  are  free  to  cancel  anytime.  Premium  rates  are  subject  to  change.  Rates  disclosed  are  accurate  as  of  the  printing  date  of  this 
disclosure. The underwriters referenced below reserve the right to modify the terms and conditions of the insurance certificates and/or policies 
upon written notice and subject to state regulations. 

COVERAGE IS ONLY AVAILABLE IN:  Oklahoma 

LIFE, DISABILITY AND UNEMPLOYMENT COVERAGES APPLY ONLY TO THE PERSON WHOSE NAME APPEARS FIRST 
ON THE ACCOUNT.  

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LIFE COVERAGE: If you die, Chargegard will pay to the Creditor the outstanding account balance as of the date of death, up to the master 
policy maximum of $10,000.  Suicide is excluded. 

DISABILITY: If you become totally disabled, Chargegard will pay to the Creditor your scheduled minimum monthly payment due on your 
account  on  the  date  of  loss.  Benefits  begin  after  30  consecutive  days  of  disability  and  are  retroactive  to  the  first  day  of  loss.    Benefits  will 
continue  until  your  balance  on  the  date  of  loss  is  paid  off,  you  return  to  work,  you  are  no  longer  disabled,  or  you  reach  the  master  policy 
maximum of $10,000, whichever occurs first. Disability benefits are not payable for self-inflicted injury. 

UNEMPLOYMENT COVERAGE: If you become involuntarily unemployed, Chargegard will pay to the Creditor your scheduled minimum 
monthly payment due on your account as of the date of loss, until your balance is paid off, you return to work, or you reach the $10,000 master 
policy maximum, whichever occurs first. Benefits begin after 30 consecutive days of unemployment and are retroactive to the first day of loss. 
Unemployment excludes discharge for cause. 

PROPERTY  BENEFITS:  If  merchandise  purchased  on  your  account  is  damaged  or  destroyed  by  fire,  flood,  theft,  or  from  other  perils 
mentioned in your certificate, the insurance will pay to the Creditor the cost of repairing or replacing your merchandise. Coverage will not be 
provided  against  loss  or  damage  caused  by  the  insured’s  neglect  to  protect  property  during  and  after  any  covered  loss  to  the  extent  of  the 
insured’s  neglect  or  to  antiques  or  any  unique  articles.  We  do  not  insure  the  antiquity,  uniqueness,  aesthetic  or  sentimental  value  of  such 
articles. 

This coverage might duplicate existing coverages if you have a residential property insurance policy. It applies 
to any item of covered property on which you owe a debt. This coverage is primary, so it is the first source to be 
used in the event of a loss on property it covers. You may cancel this coverage at any time by calling the insurer 
at the toll-free number provided to you, or by writing to the insurer. 

The premium charges for this coverage is based on your entire outstanding balance, but the coverage only applies to tangible personal 
property purchased on an open-end credit account. Services, meals or other consumables, entertainment, finance or service fees, loan 
interest, delivery charges, or other insurance premiums, which may be part of your outstanding balance, are not covered. Therefore, 
you may be paying premiums on items not covered under your policy/certificate. 

GENERAL PROVISIONS: Maximum enrollment age is 70.  Coverage terminates at age 71.  

The  monthly  premium  charge  to  your  account  will  be  $1.326  per  $100  of  your  outstanding  balance.  The  cost  of  credit  insurance  will  be 
financed at the rate specified in your agreement with the creditor. 

Coverage is underwritten by American Bankers Life Assurance Company of Florida and American Reliable Insurance Company, 
11222 Quail Roost Drive, Miami, FL 33157-6596. The creditor has a financial interest in the sale of this insurance.  

Coverages are only available as a package. If you cancel within 30 days of receiving your certificate, we will refund your premium. Insurance 
and cost disclosures are accurate as of the printing date.  

The insurance if elected will remain in force unless (1) the Account becomes delinquent more than 90 days and the Creditor does not continue premium payments with 
respect to the account; (2) the Accountholder makes written request to terminate it; (3) the group policy terminates, or (4) the death benefit becomes payable.   The 
cancellation will not take effect until written notice is delivered to you or mailed to you at your current address as shown in our records. 

A certificate describing the insurance in more detail will be furnished within 30 days from the date of this Agreement. 

PROCESS FOR FILING A CLAIM:  If you wish to file a claim, contact us toll free at 1-800-327-5288 to report your loss.  Please have the name of your creditor available.  We 
will provide you with a claim form specific to your type of loss.  Upon receipt of the claim form, follow the instructions provided, attach any required documentation, and submit 
you claim for review. 

INSURANCE ELECTIONS:  By electing optional Chargegard insurance, I acknowledge that: I do not need to purchase this insurance to get credit and I can get similar coverage 
[including property coverage] from any insurer I choose.  Chargegard includes credit life, disability, involuntary unemployment, and property coverage to the extent available in 
my state as described in the Summary of Optional Insurance Coverages*.  I read and I meet the eligibility requirements show in the Summary of Optional Insurance Coverages*.  
Monthly premium charges are based on the account balance and the rate shown.  I will receive notice of any rate increase.  I may cancel anytime. 

Yes, please enroll me in Chargegard credit insurance. 

_______________________________________________________            
Signature   

       /         /        

       /         /        

Date of Birth 

 Date 

_______________________________________________________             
Joint Signature 

       /         /        

       /         /        

Date of Birth 

 Date 

No, do not enroll me in Chargegard credit insurance. 

_________________________________________________             
Signature   

       /         /        

Date 

N1990-0299 

If you notice the loss or theft of your credit card or a possible unauthorized use of your card, you should write to us immediately at: 

Conn’s 
P.O. Box 2358 
Beaumont, TX  77704 

or call us at 1-800-511-5750.  You may also contact us on the Web: www.conns.com/contacts/. 

You will not be liable for any unauthorized use that occurs after you notify us. You may, however, be liable for unauthorized use that occurs before your notice to us. In any case, 
your liability will not exceed $50. 

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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: 

Conn’s 
P.O. Box 2358 
Beaumont, TX  77704 

You may also contact us on the Web: www.conns.com/contacts/ 

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 or electronically at our website. 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 or electronically at: 

Conn’s 
P.O. Box 2358 
Beaumont, TX  77704 
www.conns.com/contacts/ 

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. 

Privacy Notice Acknowledgement 

I acknowledge receipt of Conn’s Privacy Notice:  

Customer Name: 

Date:  

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