REVOLVING CREDIT – Home Improvement
Each applicant may apply for individual or joint credit regardless of marital status. This application is for:

 Individual Credit – complete applicant information.
 Joint Credit with Spouse as Joint Applicant – complete applicant and co-applicant information.
 Joint Credit with Non-Spouse as Joint Applicant – complete applicant and co- applicant information.

We intend to apply for joint credit:
_______________________________________     ________________________________________
Applicant Sign Here 
DEALER USE ONLY
Applicant’s identification was verified via viewing an unexpired driver’s license unless one of the following 
is checked: Unexpired:   ___ State Issued ID Card     ___ Passport     ___Social Security Card
Co-Applicant’s identification was verified via viewing an unexpired driver’s license unless one of the 
following is checked:   Unexpired:   ___ State Issued ID Card    ___ Passport     ___Social Security Card

              Co-Applicant Sign Here

Verified By:  __________________________________________________________________________

Dealer#___________________Initial Sale $_________________Down Payment $________________
In this Agreement “you” and “your” refer to all persons applying for credit and “we”, “us”, and “our” 
refer to Dealer and its assigns. 

CUSTOMER CREDIT APPLICATION
APPLICANT INFORMATION   (Please Type or Print Clearly)

Check if you are NOT a US Citizen             
Social Security Number             Date of Birth            E-Mail Address                                     

No. of Dependents

First Name                                      Middle                        Last Name

Residence Address (No PO Box allowed)                                     Time at Residence

                                                                                                           Yrs.             Mos.
City                                                              State                                      Zip

 Own                              Monthly Mortgage Payment                   Home Value                                      

 Rent                              $                                                         $                                                                                                                                        

Home Phone Number                 Cell Phone Number                      Work Phone Number

             /                /                            /                /                                 /                /
Present Employer             Occupation                     Gross Monthly Salary   Length of Employment

                                                                              $                                           Yrs.       Mos.
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 this obligation.
Other Income                     Source                                               Monthly Amount

$                                                                                                $

PERSONAL REFERENCE   (Not Living With You)

Name

Relationship                                                                 Phone Number
                                                                                                                 /                   /

CO-APPLICANT INFORMATION   (For Joint Applications Only)

Check if you are NOT a US Citizen             
Social Security Number             Date of Birth            E-Mail Address                                     

No. of Dependents

First Name                                      Middle                        Last Name

Residence Address (No PO Box allowed)                                     Time at Residence

                                                                                                           Yrs.             Mos.
City                                                              State                                      Zip

Home Phone Number                 Cell Phone Number                      Work Phone Number

             /                /                            /                /                                 /                /
Present Employer             Occupation                     Gross Monthly Salary   Length of Employment

                                                                              $                                           Yrs.       Mos.
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 this obligation.
Other Income                     Source                                               Monthly Amount

$                                                                                                $
By signing this application: 1) you warrant all information you provide is true and complete; 2) you authorize 
Dealer to assign this application to Aqua Finance, Inc. or its assigns; 3) you authorize a full investigation 
and release of any records from any source, including credit bureau reports, to check the accuracy of 
information on this application  ; and 4) you consent to receiving autodialed message calls from us or our 
agents on your wireless phone. You have a continuing duty to keep us informed if any information on this 
application changes. By completing and signing this application you understand that you have requested 
that  we  open  a  revolving  credit  account  which  allows  you  to  make  credit  purchases  on  account  as 
evidenced by a revolving credit sales slip, and you agree to all the terms and conditions of this Revolving 
Credit Agreement. By your signature you acknowledge that you have received and read all the terms of 
this Agreement before making any purchases on the account.
AFI-550-RCA  2-15-2014 home improvement   176307
AFI-550-RCA  2-15-2014 home improvement   176307

IF  THIS  IS  A  JOINT  ACCOUNT  YOU  UNDERSTAND  THAT  EACH  APPLICANT  HAS  THE  RIGHT 
TO USE THE ACCOUNT TO THE CREDIT LIMIT AND THAT CO-APPLICANTS ARE JOINTLY AND 
SEVERALLY LIABLE FOR ALL PURCHASES ON THE ACCOUNT.  See State Notices for important 
information regarding this credit application and agreement. No agreement exists between us until 
this application is approved. 
SOCIAL  SECURITY  NUMBER/TAXPAYER  IDENTIFICATION  NUMBER:    Under  penalties  of  perjury,  I 
certify that: 1)The number shown on Page 1 of this Credit Application is my correct taxpayer identification 
number (or I am waiting for a number to  be issued to me),  2) I am not subject to backup withholding because: 
(a) I am exempt from backup withholding; or (b) I have not been notified by the Internal Revenue Service (IRS) 
that I am subject to backup withholding as a result of a failure to report all interest or dividends; or (c) the IRS 
has notified me that I am no longer subject to backup withholding; and 3) I am a U.S. person (including a U.S. 
resident alien). Certification Instructions: Cross out item 2 above if you have been notified by the IRS that 
you are currently subject to backup withholding because you have failed to report all interest and dividends 
on your tax return.  Cross out item 3 and complete a W-8 BEN if you qualify and are not a U. S. Person.
The Internal Revenue Service does not require your consent to any provision of this document 
other than the certification required to avoid backup withholding.
Your  Minimum  Monthly  Payment  will  be  between  2%  and  5%  of  the  “Highest  Monthly  Charge” 
balance since your Monthly Charge Balance was zero (less any Special Payment Plans) as will be 
shown on your billing statement, rounded to the next highest dollar, or $15, whichever is greater.  If 
you are a participant in specified Promotion Plans, your Minimum Monthly Payment will be between 
1%  (for  first  12  months)  and  2%  (thereafter)  of  the  “Highest  Monthly  Charge”  balance  or  $15, 
whichever is greater.  A finance charge will be computed on your outstanding balance each month.
DO  NOT  SIGN  BELOW  UNLESS  MERCHANT  HAS  PROVIDED  THE  ATTACHED  DISCLOSURES 
AND TERMS. BY YOUR SIGNATURE BELOW YOU ACKNOWLEDGE RECEIPT OF THE ATTACHED 
REVOLVING CREDIT AGREEMENT.

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Applicant Signature                                                                             Date

                                                                                                                        /           /
Applicant Drivers Lic. No.                              State                                 Expiration Date

                                                                                                                        /           /
Joint Applicant Signature                                                                    Date

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Penalty APR and 

When it Applies**

                                                                                                                        /           /
Joint Applicant Drivers Lic. No.                     State                                   Expiration Date
NOTICE  TO  WISCONSIN  APPLICANTS:  No  provision  of  a  marital  property  agreement,  a  unilateral 
statement under Wis. Stats. §766.59, or a court decree under Wis. Stats. §766.70 adversely affect the 
interest of the creditor unless the creditor is furnished a copy of the decree, agreement, statement, or has 
actual knowledge of the adverse provision prior to the time credit is granted. You must supply us with your 
spouse’s name and address in the Spouse/Joint Applicant section above so we can give notice of this 
credit transaction by mailing a copy of this application.  If you are married, you agree that this obligation is 
incurred in the interest of marriage or family. 
Applicant Signature:___________________________________________________________________
CREDIT REPORT NOTICE: We may request a credit report for any legitimate purpose associated with 
your application for credit, extending credit, modifying the terms of your credit agreement, or collection on 
your account. On your request we will inform you if such a report was ordered and will give you the name 
and address of the credit reporting agency that furnished the report.
NOTICE: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit 
applicants  on  the  basis  of  race,  color,  religion,  national  origin,  sex,  marital  status,  age  (provided  the 
applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income 
derives from any public assistance program; or because the applicant has in good faith exercised any right 
under the Consumer Credit Protection Act.  The Federal agency that administers compliance with the law 
concerning this creditor is the Federal Trade Commission.
Delaware residents: Service charges not in excess of those permitted by law will be charged on 
the outstanding balances from month to month.
Maryland residents: Finance charges will be made in amounts or at rates not in excess of those 
permitted by law.
ASSIGNMENT: Should Aqua Finance, Inc. (“AFI”) acquire your account as a result of your credit application, 
AFI may further assign your credit transaction to a credit union which may require you to be a member.  In 
that event, and by signing this application, you agree to the terms of membership as set forth below:
I apply for membership in and agree to the terms and conditions as provided, and I agree to conform to 
the  bylaws  and  any  amendments  of  any  credit  union  which  accepts  assignment  of  my  credit  transaction.  
I  authorize  the  credit  union  to  check  my  account,  credit,  and  employment  history,  and  to  obtain  a  credit 
report now or in the future.  I understand that this will assist the credit union, for example, in determining my 
initial and ongoing eligibility for my/our Account and/or in connection with making future credit opportunities 
available to me.  This is not a marital account.  If the initial share is deposited by the credit union, it will be 
revoked if no additional deposits or loans are added to my membership within one year of membership date.  
It is agreed that if more than one person signs this application, this account is jointly held by the parties named 
hereon.  Upon the death of any of them, ownership or all funds in this account are passed to the survivor.

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AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTS
 I hereby authorize the initiation of a periodic deduction from my account at the financial institution 
named  below  through  the  ACH  system  and  authorize  said  institution  to  debit  my  account  for  the 
amount and at the frequency set forth below.  I acknowledge that this request does not violate the 
provisions of United States law as it applies to ACH transactions.  I understand I have a right to stop 
this automatic payment by notifying either the institution named below or AFI, in writing, at least three 
(3) business days prior to the day my account is scheduled to be charged and that there may be a fee 
for that service.  Further I agree that AFI will require written confirmation of an oral stop-payment order 
within fourteen (14) days.  This will be a permanent stop payment on this preauthorized payment.  I 
may, however, establish a new preauthorized payment from the same financial institution or company 
in the future.  I also authorize adjustment entries in the event of erroneous transactions on my account.  
I agree to hold AFI harmless for any expenses, including fees, incurred as a result of its inability to 
process a scheduled preauthorized withdrawal due to:  my having supplied incorrect information, its 
having acted on a stop payment order, or there being insufficient funds in the account I have indicated.

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Monthly Payment______________________  Monthly Withdrawal Start Date______________________

Bank Name  _____________________________________________________________________

Bank Address  ___________________________________________________________________
IMPORTANT: PLEASE ATTACH A VOIDED CHECK WITH CORRECT ENCODING INFORMATION
Bank Routing Number_____________________ Depositor Account Number _______________
Type of Account: 
X_____________________________________   X ______________________________________
Signature of Depositor                                       (if joint account, both must sign)

 Checking 

 Savings

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 I would like to receive my monthly account statements by email and have access to pay my bill online.  

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IMPORTANT INFORMATION ABOUT YOUR ACCOUNT

KEEP THIS INFORMATION FOR YOUR RECORD

REVOLVING CREDIT AGREEMENT AND DISCLOSURE STATEMENT

Dealer  may  assign  all  rights  under  this  Agreement  and  any  credit  sale  made  pursuant  to  it  (as 

evidenced by a revolving credit sales slip) to Aqua Finance, Inc. (“AFI”) and to AFI’s further assigns.

17.99% All other states 

***Not all offers will contain introductory rates. If not otherwise specified 

on Revolving Credit Sales Slip or Promo Addendum, then your APR is the 

maximum non-introductory state APR in table, below.  

Texas, and Wyoming.

*Maximum Non-Introductory State  APR  Rates

12.00% Connecticut

14.40% Michigan

14.76% Pennsylvania 17.00% Arkansas

Interest Rates and Interest Charges

Annual Percentage Rate 

(APR) for Purchases 

9.  DEFAULT:    You  are  in  default  if:  (a)  you  fail  to  make  a  required  payment  when  due  on  two 

occasions in any 12 month period; (b) you fail to observe or perform any of the other covenants or 

duties contained in this Agreement if the failure materially impairs the condition, value or protection 

of  our  right  in  any  Collateral,  or  materially  impairs  your  ability  to  pay  any  amounts  on  your  billing 

statement when due. You will receive a Notice of Right to Cure in the following states: Colorado, Iowa, 

Kansas, Maine, Massachusetts, Nebraska, Pennsylvania, and Wisconsin. If you fail to cure within the 

time allowed in your notice or within 30 days if you live in a state with no notice requirement, we may 

10. SPECIAL CREDIT PROMOTION PLANS: We may occasionally offer special credit promotion 

plans for you to participate in at your option.

11. LATE FEE:  If your payment is more than 10 days late (15 days in ME, MA or SD and 30 days 

in NC), you may be charged a late fee up to the amount indicated below for your state of residence.  

The late fee will be added to your account balance.

KS & MO if payment due is less than $25

AK, AR, CA, FL, KS, MO, MT, NJ, NC, OH, RI, SD, TN  

CO, IN, IA, MS, NV, NH, NY, ND, OR, VT, WA, WI

$5

$10

$15

$25

MN -$7.80 maximum                           5% of payment due

5% of payment due;  $35 maximum*

** The penalty APR rate does not apply in the following states: Arkansas, Colorado, Connecticut, 

Delaware,  Florida,  Illinois,  Kansas,  Louisiana,  Maine,  Maryland,  Massachusetts,  Michigan, 

Minnesota,  Nebraska,  North  Carolina,  Oklahoma,  Pennsylvania,  Rhode  Island,  South  Carolina, 

accelerate your balance.

1. GENERAL:  If your credit application is approved and we open a revolving credit account for you, 

you may purchase household goods and services on credit from the dealer where you opened your 

account. Purchases are pursuant to a revolving credit sales slip and you agree that all sales are subject 

to the terms of this Agreement. 

2.  PROMISE  TO  PAY:    You  agree  to  pay  for  all  purchases  made  on  your  account,  INTEREST 

CHARGES,  and  other  applicable  charges  or  fees  under  this  Agreement  incurred  by  you  or  anyone 

you authorize or permit to use your account. If this account is a joint account, each joint account holder 

agrees to pay, and all account holders are jointly and severally responsible for all amounts owed on 

the account. If your account is referred for collections to an attorney who is not our salaried employee, 

you agree to pay reasonable attorney fees and reasonable collection costs to the extent allowed by 

law in your state. If your state does not allow attorney fees (IA, ME, OH, and WI), you agree to pay any 

statutory attorney fees and costs that may be awarded to us by a court of law. 

3. CREDIT LIMIT:  We set a credit limit on your account which we may modify at any time for any reason 

not prohibited by law. You may not charge purchases if it causes you to exceed your credit limit unless 

we allow such purchases. You agree to pay all amounts over your credit limit.

GA

KY & WY ($10 minimum);

AL, ID & MI ($15 minimum);

HI, NE, VA

UT

OK ($5 minimum)

TX, D.C.

AZ, CT, IL, LA, MD, ME, PA

4. BILLING STATEMENT:  We will mail you a statement each month you have an account balance 

greater than $1.00 at the address we have in our records. This statement will show credit purchases, 

late  charges,  NSF  fees,  previous  balance,  new  balance,  payments  received,  credits,  INTEREST 

NM, SC

MA

CHARGES, total minimum payment due, and payment due date.

*($25 maximum-first occurrence in more than 6 months.)

5% of payment due; $30 maximum*

5% of payment due; $20 maximum

5% of payment due; $15 maximum

5% of payment due; $10 maximum

5% of payment due; $5 maximum

10% of payment due; $10 maximum

Introductory rates between 0% and

9.9%, ranging from 6 months to 12 

months.***  Non-introductory rates

between 5.9% and 17.99%.

All rates are based on the specific 

promotion or your credit worthiness, and 

dealer participation. (Maximum APR 

Varies By State. See table below *)

21%  (see table below for 

applicability in your state**)

This APR may be applied to your 

account if you make a late payment.  

How Long Will the Penalty Rate 

Apply?:  The Penalty APR may 

remain in effect indefinitely.

Interest Charges begin on the date a 

purchase is posted to your account, 

except in states requiring a grace 

period, in which case your due date 

is at least 25 days after the close 

of each billing cycle and we will not 

charge you interest if you pay your 

entire balance by the due date.

Paying Interest 

Minimum Interest Charge

If you are charged interest, the charge 

will be no less than $0.50.

For Credit Card Tips from 

To learn more about factors to consider 

the Consumer Financial 

Protection Bureau 

Fees 

Penalty  Fees

(cid:127) Late Payment 

(cid:127) Returned Payment 

when  applying  for  or  using  a  credit 

card,  visit  the  Consumer  Financial 

Protection Bureau’s website at

http://www.consumerfinance.gov/

learnmore.

Fees Vary By State

Up to $35 See Paragraph 11 of Agreement

Up to $35 See Paragraph 12 of Agreement

Loss of Introductory APR: We may end your introductory APR and apply the 

Penalty APR if you make a late payment.

Billing  Rights:  Information  on  your  rights  to  dispute  transactions  and  how  to 

exercise those rights is provided in your account agreement.

This  information  is  accurate  on  the  date  of  your  application  and  initial 

purchase.  If any of this information changes you will be notified at least 45 

days prior to any change and how to contact us regarding any change.  All 

terms are subject to change. 

How  We  Will  Calculate  Your  Balance:  We  use  a  method  called  the  “Daily 

Balance  (including  new  purchases).”    See  your  account  Agreement  for  more 

fund transfer from your account.

than the Total Minimum Monthly Payment and you may pay the entire amount due at any time. The 

CT, D.C., ID, IA, NY, OH, PA, UT, VT

5.  MINIMUM  MONTHLY  PAYMENT:    All  payments,  except  disputed  payments,  must  be  mailed  or 

delivered  to  the  Payment  Processing  Center  address  shown  on  your  monthly  billing  statement.  All 

payments must be made by electronic fund transfer, check or money order. Do not send cash. Cash or 

other nonconforming methods of payment may be rejected. We may accept partial or late payments or 

checks marked “payment in full” or other restrictive endorsement without losing our right to receive the 

full amount owed. Your billing statement will include requirements for you to follow in making payments. 

Disputed payments, including those which indicate that the payment constitutes “payment in full” of the 

amount owed, must be mailed or delivered to the Customer Service address listed below. You agree 

to pay us at least the Total Minimum Monthly Payment reflected on your statement. You may pay more 

Total Minimum Monthly Payment Due shown on your billing statement will be the sum of the Minimum 

Monthly  Payment  plus  all  past  due  amounts,  late  fees,  and  other  charges.    The  Minimum  Monthly 

Payment is calculated at the end of the first month in which you make a purchase, and will be calculated 

each  month  in  which  you  make  an  additional  purchase.    Your  Minimum  Monthly  Payments  will  be 

between  2%  and  5%  of  the  “Highest  Monthly  Charge”  balance  since  your  Monthly  Charge  Balance 

was zero (or if you participate in specified Promotion Plans, Your Minimum Monthly Payments will be 

between 1% and 2% of the “Highest Monthly Charge” balance since your Monthly Charge Balance was 

zero), less any Special Payment Plans as shown on your billing statement rounded to the next higher 

dollar, or $15, whichever is greater, unless your account balance is less than $15 in which case the 

Minimum Monthly Payment will be equal to the account balance. You agree that any payment may 

be returned if your check is (i) not drawn in U.S. dollars on funds on deposit in the U.S.; (ii) missing a 

signature; (iii) drawn with different numeric and written amounts; (iv) contains a restrictive endorsement; 

(v) postdated; or (vi) not paid on presentment.  If you do not make a Total Minimum Monthly Payment 

within 60 days of its due date, we may apply the Penalty APR to your account, if allowed by the state of 

your residence.  We will give you advanced notice of the date the Penalty APR is effective.  The Penalty 

APR may remain in effect indefinitely, unless you make the first six consecutive Total Minimum Monthly 

Payments when due following the effective date of the application of the Penalty APR to your account.

6.  ELECTRONIC  FUND  TRANSFER:    When  you  provide  a  check,  you  authorize  us  either  to  use 

information from your check to make a one-time electronic fund transfer from your account or to process 

the transaction as a check.  When we use your check to make an electronic fund transfer, funds may 

be withdrawn from your account as soon as the same day we receive your payment, and you may not 

receive your check back from your financial institution. If there are insufficient funds in your account you 

authorize us to charge an NSF Fee as indicated below and collect that amount through an electronic 

7. PREPAYMENT:  You may pay your entire account balance at any time without penalty.  If you do 

not pay the entire balance in full, you must make a minimum payment each month by the payment 

due date that appears on your billing statement. Under federal law, we are not required to refund any 

amounts less than $1.00.

8. INTEREST CHARGE:  INTEREST CHARGES begin the date a purchase is posted to your account 

and accrue as long as your account has a balance, except in states with a mandatory grace period.  

The INTEREST CHARGE is computed by applying a daily periodic rate of between 0% and .02712% 

(corresponding to an APR of 9.9%) for an Introductory APR, or between .01616% (corresponding to 

an APR of 5.9%) and .04929% (corresponding to an APR of 17.99%) for a Non-Introductory APR, to 

the daily balance.  The daily balance is calculated by taking the beginning balance in the account each 

day, adding any new purchases and subtracting any unpaid interest or other finance charges and any 

payments  and  credits.    The  INTEREST  CHARGE  is  calculated  by  (i)  taking  each  daily  balance,  (ii) 

multiplying  that  daily  balance  by  the  applicable  daily  periodic  rate,  (iii)  adding  together  the  resulting 

amounts for each day in the billing cycle. The total periodic INTEREST CHARGES for the billing cycle 

is the sum of the periodic INTEREST CHARGES for each purchase type rounded to the next highest 

$10

$15

$20

$25

$30*

$35*

12.  RETURNED  PAYMENT  /  NSF  FEE:    If  any  payment  instrument  or  method  is  dishonored  by 

your bank or the drawee, you agree to pay an NSF fee up to the amount indicated below for your 

state of residence.  No NSF fee will be charged if your state of residence is DE, MD, NE or WY.  If 

required by your state, you will receive a notice with instructions about the NSF service or collection 

fees, and if you fail to pay the fee we will add it to your account balance.  We are not required to 

present payment instruments more than once to the drawee for payment. This fee will be added to 

your account balance. 

MA, ME, AZ (greater of $10 or bank fee)

CA, MS, MO

AR, CO, FL, IL, IN, KY, LA, MI, MN, NV, NH, NM, NC, OK, OR, RI, TX, WI 

AL, AK, GA, HI, KS, MT, SC, SD, TN

ND, VA, WA

*($25 maximum-first occurrence in more than 6 months.)

13. ACCOUNT INFORMATION:  You authorize us to furnish information about your account to credit 

reporting  agencies  and  anyone  else  who  may  lawfully  receive  such  information.  On  request,  you 

agree to promptly provide us with accurate and updated financial and employment information. You 

agree to give us prompt notice of any change in your name, address, and telephone numbers. Where 

allowed by law, you authorize the Department of Motor Vehicles to release your address if it becomes 

necessary to locate you.

14. CHANGE IN TERMS:  We may change the terms of this Agreement, as permitted by law, at any 

time. You will be notified of changes in accordance with applicable state and federal law, but in the 

event your state does not specify a time period, you will be notified at least 45 days in advance of any 

such changes, and such notice will be sent to your current address as shown on our records for your 

account. We count the days from the date we mail the notification. 

15. CREDIT INVESTIGATION:  You agree we may investigate your credit, employment, and financial 

status. You authorize us to obtain a credit report and any other information about your creditworthiness 

in connection with processing your application for credit, and subsequently in connection with any 

extension of credit, request to increase credit limits, or any renewal or update of your account, or to 

take collection action on the account, or to investigate disputes regarding the account. At your request, 

we will inform you if such reports were ordered, and the names of the credit bureaus that provided 

reports. You authorize the Department of Defense and its various departments and commands to 

verify your social security number or other identifier and disclose your home address to the authorized 

holder of this Agreement for purposes of performing or enforcing the terms of this Agreement. You 

authorize any past or present employer to confirm employment or communicate with us regarding your 

indebtedness to us if you fail to meet the terms and conditions of this Agreement. We use information 

furnished solely in connection with performing or enforcing the terms of this Agreement. 

16. ACCOUNT CANCELLATION:  We may cancel your account at any time for any reason subject to 

the requirements of applicable law. Outstanding balances continue to accrue INTEREST CHARGES 

until paid in full, and remain subject to all terms and conditions of this Agreement. You may cancel 

your account by writing to our account service provider Aqua Finance, Inc., P.O. Box 844, Wausau, 

WI 54402-0844. Your notice is effective on receipt. If you cancel your Account, you are still responsible 

for all amounts owed pursuant to the terms of this Agreement. 

17.  ASSIGNMENT:    This  Agreement  is  not  effective  until  your  application  has  been  approved  by 

AFI. We have the right to assign any or all of our rights under this Agreement to any assignee of our 

choosing.  You may not assign this Agreement or any rights under it and any attempt to make such 

an assignment will be null and void. You understand that Dealer and AFI are independent entities and 

not employees or agents of one another. This Agreement legally binds the parties and their respective 

heirs, representatives, executors, administrators, successors and assigns.  

18. SEVERABILITY:  If any provision of this Agreement is deemed void or unenforceable under any 

19.  NON-WAIVER:  We do not lose any of our rights under this Agreement if we delay taking action 

20. REPRESENTATION:  You swear that all the information you supplied on your credit application 

and all the information on each revolving credit sales slip is and will be true, correct, and accurate. 

Any false, incorrect, or misleading information you knowingly supply is a deliberate misrepresentation. 

cent.  Any Daily Balance less than zero will be treated as zero. A minimum INTEREST CHARGE of no 

law, rule, or regulation, all other provisions remain in effect and enforceable. 

less than $0.50 is added to your account in any billing cycle your account is subject to an INTEREST 

CHARGE, except in states where prohibited by law. The grace period is 25 days in Louisiana, Maine, 

for any reasons.

Maryland, Massachusetts, Mississippi, North Carolina, and Virginia and 30 days in Nebraska & Vermont 

on new purchases where your account balance is $0 or you have paid your previous balance due in 

full by the end of the billing cycle. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
REVOLVING CREDIT – Home Improvement

Each applicant may apply for individual or joint credit regardless of marital status. This application is for:

 Individual Credit – complete applicant information.

 Joint Credit with Spouse as Joint Applicant – complete applicant and co-applicant information.

 Joint Credit with Non-Spouse as Joint Applicant – complete applicant and co- applicant information.

this application is approved. 

IF  THIS  IS  A  JOINT  ACCOUNT  YOU  UNDERSTAND  THAT  EACH  APPLICANT  HAS  THE  RIGHT 

TO USE THE ACCOUNT TO THE CREDIT LIMIT AND THAT CO-APPLICANTS ARE JOINTLY AND 

SEVERALLY LIABLE FOR ALL PURCHASES ON THE ACCOUNT.  See State Notices for important 

information regarding this credit application and agreement. No agreement exists between us until 

We intend to apply for joint credit:

_______________________________________     ________________________________________

Applicant Sign Here 

              Co-Applicant Sign Here

DEALER USE ONLY

Applicant’s identification was verified via viewing an unexpired driver’s license unless one of the following 

is checked: Unexpired:   ___ State Issued ID Card     ___ Passport     ___Social Security Card

Co-Applicant’s identification was verified via viewing an unexpired driver’s license unless one of the 

following is checked:   Unexpired:   ___ State Issued ID Card    ___ Passport     ___Social Security Card

Verified By:  __________________________________________________________________________

Dealer#___________________Initial Sale $_________________Down Payment $________________

In this Agreement “you” and “your” refer to all persons applying for credit and “we”, “us”, and “our” 

refer to Dealer and its assigns. 

CUSTOMER CREDIT APPLICATION

APPLICANT INFORMATION   (Please Type or Print Clearly)

Check if you are NOT a US Citizen             

No. of Dependents

SOCIAL  SECURITY  NUMBER/TAXPAYER  IDENTIFICATION  NUMBER:    Under  penalties  of  perjury,  I 

certify that: 1)The number shown on Page 1 of this Credit Application is my correct taxpayer identification 

number (or I am waiting for a number to  be issued to me),  2) I am not subject to backup withholding because: 

(a) I am exempt from backup withholding; or (b) I have not been notified by the Internal Revenue Service (IRS) 

that I am subject to backup withholding as a result of a failure to report all interest or dividends; or (c) the IRS 

has notified me that I am no longer subject to backup withholding; and 3) I am a U.S. person (including a U.S. 

resident alien). Certification Instructions: Cross out item 2 above if you have been notified by the IRS that 

you are currently subject to backup withholding because you have failed to report all interest and dividends 

on your tax return.  Cross out item 3 and complete a W-8 BEN if you qualify and are not a U. S. Person.

The Internal Revenue Service does not require your consent to any provision of this document 

other than the certification required to avoid backup withholding.

Your  Minimum  Monthly  Payment  will  be  between  2%  and  5%  of  the  “Highest  Monthly  Charge” 

balance since your Monthly Charge Balance was zero (less any Special Payment Plans) as will be 

shown on your billing statement, rounded to the next highest dollar, or $15, whichever is greater.  If 

you are a participant in specified Promotion Plans, your Minimum Monthly Payment will be between 

1%  (for  first  12  months)  and  2%  (thereafter)  of  the  “Highest  Monthly  Charge”  balance  or  $15, 

whichever is greater.  A finance charge will be computed on your outstanding balance each month.

DO  NOT  SIGN  BELOW  UNLESS  MERCHANT  HAS  PROVIDED  THE  ATTACHED  DISCLOSURES 

AND TERMS. BY YOUR SIGNATURE BELOW YOU ACKNOWLEDGE RECEIPT OF THE ATTACHED 

REVOLVING CREDIT AGREEMENT.

Social Security Number             Date of Birth            E-Mail Address                                     

                                                                                                                        /           /

First Name                                      Middle                        Last Name

Residence Address (No PO Box allowed)                                     Time at Residence

                                                                                                           Yrs.             Mos.

City                                                              State                                      Zip

 Own                              Monthly Mortgage Payment                   Home Value                                      

 Rent                              $                                                         $                                                                                                                                        

Home Phone Number                 Cell Phone Number                      Work Phone Number

             /                /                            /                /                                 /                /

Present Employer             Occupation                     Gross Monthly Salary   Length of Employment

                                                                              $                                           Yrs.       Mos.

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 this obligation.

Other Income                     Source                                               Monthly Amount

$                                                                                                $

PERSONAL REFERENCE   (Not Living With You)

Name

Relationship                                                                 Phone Number

                                                                                                                 /                   /

permitted by law.

CO-APPLICANT INFORMATION   (For Joint Applications Only)

Check if you are NOT a US Citizen             

No. of Dependents

Social Security Number             Date of Birth            E-Mail Address                                     

First Name                                      Middle                        Last Name

Residence Address (No PO Box allowed)                                     Time at Residence

                                                                                                           Yrs.             Mos.

City                                                              State                                      Zip

Home Phone Number                 Cell Phone Number                      Work Phone Number

             /                /                            /                /                                 /                /

Present Employer             Occupation                     Gross Monthly Salary   Length of Employment

                                                                              $                                           Yrs.       Mos.

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 this obligation.

Other Income                     Source                                               Monthly Amount

$                                                                                                $

By signing this application: 1) you warrant all information you provide is true and complete; 2) you authorize 

Dealer to assign this application to Aqua Finance, Inc. or its assigns; 3) you authorize a full investigation 

and release of any records from any source, including credit bureau reports, to check the accuracy of 

information on this application  ; and 4) you consent to receiving autodialed message calls from us or our 

agents on your wireless phone. You have a continuing duty to keep us informed if any information on this 

application changes. By completing and signing this application you understand that you have requested 

that  we  open  a  revolving  credit  account  which  allows  you  to  make  credit  purchases  on  account  as 

evidenced by a revolving credit sales slip, and you agree to all the terms and conditions of this Revolving 

Credit Agreement. By your signature you acknowledge that you have received and read all the terms of 

this Agreement before making any purchases on the account.

AFI-550-RCA  2-15-2014 home improvement   176307

Applicant Signature                                                                             Date

                                                                                                                        /           /

Applicant Drivers Lic. No.                              State                                 Expiration Date

                                                                                                                        /           /

Joint Applicant Signature                                                                    Date

                                                                                                                        /           /

Joint Applicant Drivers Lic. No.                     State                                   Expiration Date

NOTICE  TO  WISCONSIN  APPLICANTS:  No  provision  of  a  marital  property  agreement,  a  unilateral 

statement under Wis. Stats. §766.59, or a court decree under Wis. Stats. §766.70 adversely affect the 

interest of the creditor unless the creditor is furnished a copy of the decree, agreement, statement, or has 

actual knowledge of the adverse provision prior to the time credit is granted. You must supply us with your 

spouse’s name and address in the Spouse/Joint Applicant section above so we can give notice of this 

credit transaction by mailing a copy of this application.  If you are married, you agree that this obligation is 

incurred in the interest of marriage or family. 

Applicant Signature:___________________________________________________________________

CREDIT REPORT NOTICE: We may request a credit report for any legitimate purpose associated with 

your application for credit, extending credit, modifying the terms of your credit agreement, or collection on 

your account. On your request we will inform you if such a report was ordered and will give you the name 

and address of the credit reporting agency that furnished the report.

NOTICE: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit 

applicants  on  the  basis  of  race,  color,  religion,  national  origin,  sex,  marital  status,  age  (provided  the 

applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income 

derives from any public assistance program; or because the applicant has in good faith exercised any right 

under the Consumer Credit Protection Act.  The Federal agency that administers compliance with the law 

concerning this creditor is the Federal Trade Commission.

Delaware residents: Service charges not in excess of those permitted by law will be charged on 

the outstanding balances from month to month.

Maryland residents: Finance charges will be made in amounts or at rates not in excess of those 

ASSIGNMENT: Should Aqua Finance, Inc. (“AFI”) acquire your account as a result of your credit application, 

AFI may further assign your credit transaction to a credit union which may require you to be a member.  In 

that event, and by signing this application, you agree to the terms of membership as set forth below:

I apply for membership in and agree to the terms and conditions as provided, and I agree to conform to 

the  bylaws  and  any  amendments  of  any  credit  union  which  accepts  assignment  of  my  credit  transaction.  

I  authorize  the  credit  union  to  check  my  account,  credit,  and  employment  history,  and  to  obtain  a  credit 

report now or in the future.  I understand that this will assist the credit union, for example, in determining my 

initial and ongoing eligibility for my/our Account and/or in connection with making future credit opportunities 

available to me.  This is not a marital account.  If the initial share is deposited by the credit union, it will be 

revoked if no additional deposits or loans are added to my membership within one year of membership date.  

It is agreed that if more than one person signs this application, this account is jointly held by the parties named 

hereon.  Upon the death of any of them, ownership or all funds in this account are passed to the survivor.

AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTS

 I hereby authorize the initiation of a periodic deduction from my account at the financial institution 

named  below  through  the  ACH  system  and  authorize  said  institution  to  debit  my  account  for  the 

amount and at the frequency set forth below.  I acknowledge that this request does not violate the 

provisions of United States law as it applies to ACH transactions.  I understand I have a right to stop 

this automatic payment by notifying either the institution named below or AFI, in writing, at least three 

(3) business days prior to the day my account is scheduled to be charged and that there may be a fee 

for that service.  Further I agree that AFI will require written confirmation of an oral stop-payment order 

within fourteen (14) days.  This will be a permanent stop payment on this preauthorized payment.  I 

may, however, establish a new preauthorized payment from the same financial institution or company 

in the future.  I also authorize adjustment entries in the event of erroneous transactions on my account.  

I agree to hold AFI harmless for any expenses, including fees, incurred as a result of its inability to 

process a scheduled preauthorized withdrawal due to:  my having supplied incorrect information, its 

having acted on a stop payment order, or there being insufficient funds in the account I have indicated.

Monthly Payment______________________  Monthly Withdrawal Start Date______________________

Bank Name  _____________________________________________________________________

Bank Address  ___________________________________________________________________

IMPORTANT: PLEASE ATTACH A VOIDED CHECK WITH CORRECT ENCODING INFORMATION

Bank Routing Number_____________________ Depositor Account Number _______________

Type of Account: 

 Checking 

 Savings

X_____________________________________   X ______________________________________

Signature of Depositor                                       (if joint account, both must sign)

 I would like to receive my monthly account statements by email and have access to pay my bill online.  

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IMPORTANT INFORMATION ABOUT YOUR ACCOUNT
KEEP THIS INFORMATION FOR YOUR RECORD

REVOLVING CREDIT AGREEMENT AND DISCLOSURE STATEMENT
Dealer  may  assign  all  rights  under  this  Agreement  and  any  credit  sale  made  pursuant  to  it  (as 
evidenced by a revolving credit sales slip) to Aqua Finance, Inc. (“AFI”) and to AFI’s further assigns.
***Not all offers will contain introductory rates. If not otherwise specified 
on Revolving Credit Sales Slip or Promo Addendum, then your APR is the 
maximum non-introductory state APR in table, below.  
Interest Rates and Interest Charges
Annual Percentage Rate 
(APR) for Purchases 

Introductory rates between 0% and
9.9%, ranging from 6 months to 12 
months.***  Non-introductory rates
between 5.9% and 17.99%.
All rates are based on the specific 
promotion or your credit worthiness, and 
dealer participation. (Maximum APR 
Varies By State. See table below *)
21%  (see table below for 
applicability in your state**)
This APR may be applied to your 
account if you make a late payment.  
How Long Will the Penalty Rate 
Apply?:  The Penalty APR may 
remain in effect indefinitely.
Interest Charges begin on the date a 
purchase is posted to your account, 
except in states requiring a grace 
period, in which case your due date 
is at least 25 days after the close 
of each billing cycle and we will not 
charge you interest if you pay your 
entire balance by the due date.
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  Consumer  Financial 
Protection Bureau’s website at
http://www.consumerfinance.gov/
learnmore.

Penalty APR and 
When it Applies**

Paying Interest 

Minimum Interest Charge

For Credit Card Tips from 
the Consumer Financial 
Protection Bureau 

Fees Vary By State
Up to $35 See Paragraph 11 of Agreement
Up to $35 See Paragraph 12 of Agreement

Fees 
Penalty  Fees
(cid:127) Late Payment 
(cid:127) Returned Payment 
How  We  Will  Calculate  Your  Balance:  We  use  a  method  called  the  “Daily 
Balance  (including  new  purchases).”    See  your  account  Agreement  for  more 
details.
Loss of Introductory APR: We may end your introductory APR and apply the 
Penalty APR if you make a late payment.
Billing  Rights:  Information  on  your  rights  to  dispute  transactions  and  how  to 
exercise those rights is provided in your account agreement.
This  information  is  accurate  on  the  date  of  your  application  and  initial 
purchase.  If any of this information changes you will be notified at least 45 
days prior to any change and how to contact us regarding any change.  All 
terms are subject to change. 

*Maximum Non-Introductory State  APR  Rates

12.00% Connecticut
14.40% Michigan
14.76% Pennsylvania 17.00% Arkansas
17.99% All other states 
** The penalty APR rate does not apply in the following states: Arkansas, Colorado, Connecticut, 
Delaware,  Florida,  Illinois,  Kansas,  Louisiana,  Maine,  Maryland,  Massachusetts,  Michigan, 
Minnesota,  Nebraska,  North  Carolina,  Oklahoma,  Pennsylvania,  Rhode  Island,  South  Carolina, 
Texas, and Wyoming.

1. GENERAL:  If your credit application is approved and we open a revolving credit account for you, 
you may purchase household goods and services on credit from the dealer where you opened your 
account. Purchases are pursuant to a revolving credit sales slip and you agree that all sales are subject 
to the terms of this Agreement. 
2.  PROMISE  TO  PAY:    You  agree  to  pay  for  all  purchases  made  on  your  account,  INTEREST 
CHARGES,  and  other  applicable  charges  or  fees  under  this  Agreement  incurred  by  you  or  anyone 
you authorize or permit to use your account. If this account is a joint account, each joint account holder 
agrees to pay, and all account holders are jointly and severally responsible for all amounts owed on 
the account. If your account is referred for collections to an attorney who is not our salaried employee, 
you agree to pay reasonable attorney fees and reasonable collection costs to the extent allowed by 
law in your state. If your state does not allow attorney fees (IA, ME, OH, and WI), you agree to pay any 
statutory attorney fees and costs that may be awarded to us by a court of law. 
3. CREDIT LIMIT:  We set a credit limit on your account which we may modify at any time for any reason 
not prohibited by law. You may not charge purchases if it causes you to exceed your credit limit unless 
we allow such purchases. You agree to pay all amounts over your credit limit.
4. BILLING STATEMENT:  We will mail you a statement each month you have an account balance 
greater than $1.00 at the address we have in our records. This statement will show credit purchases, 
late  charges,  NSF  fees,  previous  balance,  new  balance,  payments  received,  credits,  INTEREST 
CHARGES, total minimum payment due, and payment due date.
5.  MINIMUM  MONTHLY  PAYMENT:    All  payments,  except  disputed  payments,  must  be  mailed  or 
delivered  to  the  Payment  Processing  Center  address  shown  on  your  monthly  billing  statement.  All 
payments must be made by electronic fund transfer, check or money order. Do not send cash. Cash or 
other nonconforming methods of payment may be rejected. We may accept partial or late payments or 
checks marked “payment in full” or other restrictive endorsement without losing our right to receive the 
full amount owed. Your billing statement will include requirements for you to follow in making payments. 
Disputed payments, including those which indicate that the payment constitutes “payment in full” of the 
amount owed, must be mailed or delivered to the Customer Service address listed below. You agree 
to pay us at least the Total Minimum Monthly Payment reflected on your statement. You may pay more 
than the Total Minimum Monthly Payment and you may pay the entire amount due at any time. The 
Total Minimum Monthly Payment Due shown on your billing statement will be the sum of the Minimum 
Monthly  Payment  plus  all  past  due  amounts,  late  fees,  and  other  charges.    The  Minimum  Monthly 
Payment is calculated at the end of the first month in which you make a purchase, and will be calculated 
each  month  in  which  you  make  an  additional  purchase.    Your  Minimum  Monthly  Payments  will  be 
between  2%  and  5%  of  the  “Highest  Monthly  Charge”  balance  since  your  Monthly  Charge  Balance 
was zero (or if you participate in specified Promotion Plans, Your Minimum Monthly Payments will be 
between 1% and 2% of the “Highest Monthly Charge” balance since your Monthly Charge Balance was 
zero), less any Special Payment Plans as shown on your billing statement rounded to the next higher 
dollar, or $15, whichever is greater, unless your account balance is less than $15 in which case the 
Minimum Monthly Payment will be equal to the account balance. You agree that any payment may 
be returned if your check is (i) not drawn in U.S. dollars on funds on deposit in the U.S.; (ii) missing a 
signature; (iii) drawn with different numeric and written amounts; (iv) contains a restrictive endorsement; 
(v) postdated; or (vi) not paid on presentment.  If you do not make a Total Minimum Monthly Payment 
within 60 days of its due date, we may apply the Penalty APR to your account, if allowed by the state of 
your residence.  We will give you advanced notice of the date the Penalty APR is effective.  The Penalty 
APR may remain in effect indefinitely, unless you make the first six consecutive Total Minimum Monthly 
Payments when due following the effective date of the application of the Penalty APR to your account.
6.  ELECTRONIC  FUND  TRANSFER:    When  you  provide  a  check,  you  authorize  us  either  to  use 
information from your check to make a one-time electronic fund transfer from your account or to process 
the transaction as a check.  When we use your check to make an electronic fund transfer, funds may 
be withdrawn from your account as soon as the same day we receive your payment, and you may not 
receive your check back from your financial institution. If there are insufficient funds in your account you 
authorize us to charge an NSF Fee as indicated below and collect that amount through an electronic 
fund transfer from your account.
7. PREPAYMENT:  You may pay your entire account balance at any time without penalty.  If you do 
not pay the entire balance in full, you must make a minimum payment each month by the payment 
due date that appears on your billing statement. Under federal law, we are not required to refund any 
amounts less than $1.00.
8. INTEREST CHARGE:  INTEREST CHARGES begin the date a purchase is posted to your account 
and accrue as long as your account has a balance, except in states with a mandatory grace period.  
The INTEREST CHARGE is computed by applying a daily periodic rate of between 0% and .02712% 
(corresponding to an APR of 9.9%) for an Introductory APR, or between .01616% (corresponding to 
an APR of 5.9%) and .04929% (corresponding to an APR of 17.99%) for a Non-Introductory APR, to 
the daily balance.  The daily balance is calculated by taking the beginning balance in the account each 
day, adding any new purchases and subtracting any unpaid interest or other finance charges and any 
payments  and  credits.    The  INTEREST  CHARGE  is  calculated  by  (i)  taking  each  daily  balance,  (ii) 
multiplying  that  daily  balance  by  the  applicable  daily  periodic  rate,  (iii)  adding  together  the  resulting 
amounts for each day in the billing cycle. The total periodic INTEREST CHARGES for the billing cycle 
is the sum of the periodic INTEREST CHARGES for each purchase type rounded to the next highest 
cent.  Any Daily Balance less than zero will be treated as zero. A minimum INTEREST CHARGE of no 
less than $0.50 is added to your account in any billing cycle your account is subject to an INTEREST 
CHARGE, except in states where prohibited by law. The grace period is 25 days in Louisiana, Maine, 
Maryland, Massachusetts, Mississippi, North Carolina, and Virginia and 30 days in Nebraska & Vermont 
on new purchases where your account balance is $0 or you have paid your previous balance due in 
full by the end of the billing cycle. 
AFI-550-RCA  2-15-2014 home improvement   176307

9.  DEFAULT:    You  are  in  default  if:  (a)  you  fail  to  make  a  required  payment  when  due  on  two 
occasions in any 12 month period; (b) you fail to observe or perform any of the other covenants or 
duties contained in this Agreement if the failure materially impairs the condition, value or protection 
of  our  right  in  any  Collateral,  or  materially  impairs  your  ability  to  pay  any  amounts  on  your  billing 
statement when due. You will receive a Notice of Right to Cure in the following states: Colorado, Iowa, 
Kansas, Maine, Massachusetts, Nebraska, Pennsylvania, and Wisconsin. If you fail to cure within the 
time allowed in your notice or within 30 days if you live in a state with no notice requirement, we may 
accelerate your balance.
10. SPECIAL CREDIT PROMOTION PLANS: We may occasionally offer special credit promotion 
plans for you to participate in at your option.
11. LATE FEE:  If your payment is more than 10 days late (15 days in ME, MA or SD and 30 days 
in NC), you may be charged a late fee up to the amount indicated below for your state of residence.  
The late fee will be added to your account balance.

KS & MO if payment due is less than $25

AK, AR, CA, FL, KS, MO, MT, NJ, NC, OH, RI, SD, TN  

CO, IN, IA, MS, NV, NH, NY, ND, OR, VT, WA, WI

$5

$10

$15

$25

MN -$7.80 maximum                           5% of payment due

5% of payment due;  $35 maximum*

GA

KY & WY ($10 minimum);

AL, ID & MI ($15 minimum);

HI, NE, VA

UT

OK ($5 minimum)

TX, D.C.

NM, SC

MA

AZ, CT, IL, LA, MD, ME, PA

5% of payment due; $30 maximum*

5% of payment due; $20 maximum

5% of payment due; $15 maximum

5% of payment due; $10 maximum

5% of payment due; $5 maximum

10% of payment due; $10 maximum

*($25 maximum-first occurrence in more than 6 months.)
12.  RETURNED  PAYMENT  /  NSF  FEE:    If  any  payment  instrument  or  method  is  dishonored  by 
your bank or the drawee, you agree to pay an NSF fee up to the amount indicated below for your 
state of residence.  No NSF fee will be charged if your state of residence is DE, MD, NE or WY.  If 
required by your state, you will receive a notice with instructions about the NSF service or collection 
fees, and if you fail to pay the fee we will add it to your account balance.  We are not required to 
present payment instruments more than once to the drawee for payment. This fee will be added to 
your account balance. 

MA, ME, AZ (greater of $10 or bank fee)

CA, MS, MO

CT, D.C., ID, IA, NY, OH, PA, UT, VT

AL, AK, GA, HI, KS, MT, SC, SD, TN

ND, VA, WA

AR, CO, FL, IL, IN, KY, LA, MI, MN, NV, NH, NM, NC, OK, OR, RI, TX, WI 

$10

$15

$20

$25

$30*

$35*

*($25 maximum-first occurrence in more than 6 months.)
13. ACCOUNT INFORMATION:  You authorize us to furnish information about your account to credit 
reporting  agencies  and  anyone  else  who  may  lawfully  receive  such  information.  On  request,  you 
agree to promptly provide us with accurate and updated financial and employment information. You 
agree to give us prompt notice of any change in your name, address, and telephone numbers. Where 
allowed by law, you authorize the Department of Motor Vehicles to release your address if it becomes 
necessary to locate you.

14. CHANGE IN TERMS:  We may change the terms of this Agreement, as permitted by law, at any 
time. You will be notified of changes in accordance with applicable state and federal law, but in the 
event your state does not specify a time period, you will be notified at least 45 days in advance of any 
such changes, and such notice will be sent to your current address as shown on our records for your 
account. We count the days from the date we mail the notification. 

15. CREDIT INVESTIGATION:  You agree we may investigate your credit, employment, and financial 
status. You authorize us to obtain a credit report and any other information about your creditworthiness 
in connection with processing your application for credit, and subsequently in connection with any 
extension of credit, request to increase credit limits, or any renewal or update of your account, or to 
take collection action on the account, or to investigate disputes regarding the account. At your request, 
we will inform you if such reports were ordered, and the names of the credit bureaus that provided 
reports.  You authorize the  Department  of  Defense and  its  various departments and  commands  to 
verify your social security number or other identifier and disclose your home address to the authorized 
holder of this Agreement for purposes of performing or enforcing the terms of this Agreement. You 
authorize any past or present employer to confirm employment or communicate with us regarding your 
indebtedness to us if you fail to meet the terms and conditions of this Agreement. We use information 
furnished solely in connection with performing or enforcing the terms of this Agreement. 
16. ACCOUNT CANCELLATION:  We may cancel your account at any time for any reason subject to 
the requirements of applicable law. Outstanding balances continue to accrue INTEREST CHARGES 
until paid in full, and remain subject to all terms and conditions of this Agreement. You may cancel 
your account by writing to our account service provider Aqua Finance, Inc., P.O. Box 844, Wausau, 
WI 54402-0844. Your notice is effective on receipt. If you cancel your Account, you are still responsible 
for all amounts owed pursuant to the terms of this Agreement. 

17.  ASSIGNMENT:    This  Agreement  is  not  effective  until  your  application  has  been  approved  by 
AFI. We have the right to assign any or all of our rights under this Agreement to any assignee of our 
choosing.  You may not assign this Agreement or any rights under it and any attempt to make such 
an assignment will be null and void. You understand that Dealer and AFI are independent entities and 
not employees or agents of one another. This Agreement legally binds the parties and their respective 
heirs, representatives, executors, administrators, successors and assigns.  

18. SEVERABILITY:  If any provision of this Agreement is deemed void or unenforceable under any 
law, rule, or regulation, all other provisions remain in effect and enforceable. 
19.  NON-WAIVER:  We do not lose any of our rights under this Agreement if we delay taking action 
for any reasons.

20. REPRESENTATION:  You swear that all the information you supplied on your credit application 
and all the information on each revolving credit sales slip is and will be true, correct, and accurate. 
Any false, incorrect, or misleading information you knowingly supply is a deliberate misrepresentation. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
REVOLVING CREDIT – Home Improvement

Each applicant may apply for individual or joint credit regardless of marital status. This application is for:

 Individual Credit – complete applicant information.

 Joint Credit with Spouse as Joint Applicant – complete applicant and co-applicant information.

 Joint Credit with Non-Spouse as Joint Applicant – complete applicant and co- applicant information.

this application is approved. 

IF  THIS  IS  A  JOINT  ACCOUNT  YOU  UNDERSTAND  THAT  EACH  APPLICANT  HAS  THE  RIGHT 

TO USE THE ACCOUNT TO THE CREDIT LIMIT AND THAT CO-APPLICANTS ARE JOINTLY AND 

SEVERALLY LIABLE FOR ALL PURCHASES ON THE ACCOUNT.  See State Notices for important 

information regarding this credit application and agreement. No agreement exists between us until 

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We intend to apply for joint credit:

_______________________________________     ________________________________________

Applicant Sign Here 

              Co-Applicant Sign Here

DEALER USE ONLY

Applicant’s identification was verified via viewing an unexpired driver’s license unless one of the following 

is checked: Unexpired:   ___ State Issued ID Card     ___ Passport     ___Social Security Card

Co-Applicant’s identification was verified via viewing an unexpired driver’s license unless one of the 

following is checked:   Unexpired:   ___ State Issued ID Card    ___ Passport     ___Social Security Card

Verified By:  __________________________________________________________________________

Dealer#___________________Initial Sale $_________________Down Payment $________________

In this Agreement “you” and “your” refer to all persons applying for credit and “we”, “us”, and “our” 

refer to Dealer and its assigns. 

CUSTOMER CREDIT APPLICATION

APPLICANT INFORMATION   (Please Type or Print Clearly)

Check if you are NOT a US Citizen             

No. of Dependents

SOCIAL  SECURITY  NUMBER/TAXPAYER  IDENTIFICATION  NUMBER:    Under  penalties  of  perjury,  I 

certify that: 1)The number shown on Page 1 of this Credit Application is my correct taxpayer identification 

number (or I am waiting for a number to  be issued to me),  2) I am not subject to backup withholding because: 

(a) I am exempt from backup withholding; or (b) I have not been notified by the Internal Revenue Service (IRS) 

that I am subject to backup withholding as a result of a failure to report all interest or dividends; or (c) the IRS 

has notified me that I am no longer subject to backup withholding; and 3) I am a U.S. person (including a U.S. 

resident alien). Certification Instructions: Cross out item 2 above if you have been notified by the IRS that 

you are currently subject to backup withholding because you have failed to report all interest and dividends 

on your tax return.  Cross out item 3 and complete a W-8 BEN if you qualify and are not a U. S. Person.

The Internal Revenue Service does not require your consent to any provision of this document 

other than the certification required to avoid backup withholding.

Your  Minimum  Monthly  Payment  will  be  between  2%  and  5%  of  the  “Highest  Monthly  Charge” 

balance since your Monthly Charge Balance was zero (less any Special Payment Plans) as will be 

shown on your billing statement, rounded to the next highest dollar, or $15, whichever is greater.  If 

you are a participant in specified Promotion Plans, your Minimum Monthly Payment will be between 

1%  (for  first  12  months)  and  2%  (thereafter)  of  the  “Highest  Monthly  Charge”  balance  or  $15, 

whichever is greater.  A finance charge will be computed on your outstanding balance each month.

DO  NOT  SIGN  BELOW  UNLESS  MERCHANT  HAS  PROVIDED  THE  ATTACHED  DISCLOSURES 

AND TERMS. BY YOUR SIGNATURE BELOW YOU ACKNOWLEDGE RECEIPT OF THE ATTACHED 

REVOLVING CREDIT AGREEMENT.

Social Security Number             Date of Birth            E-Mail Address                                     

                                                                                                                        /           /

First Name                                      Middle                        Last Name

Residence Address (No PO Box allowed)                                     Time at Residence

                                                                                                           Yrs.             Mos.

City                                                              State                                      Zip

 Own                              Monthly Mortgage Payment                   Home Value                                      

 Rent                              $                                                         $                                                                                                                                        

Home Phone Number                 Cell Phone Number                      Work Phone Number

             /                /                            /                /                                 /                /

Present Employer             Occupation                     Gross Monthly Salary   Length of Employment

                                                                              $                                           Yrs.       Mos.

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 this obligation.

Other Income                     Source                                               Monthly Amount

$                                                                                                $

PERSONAL REFERENCE   (Not Living With You)

Name

Relationship                                                                 Phone Number

                                                                                                                 /                   /

permitted by law.

CO-APPLICANT INFORMATION   (For Joint Applications Only)

Check if you are NOT a US Citizen             

No. of Dependents

Social Security Number             Date of Birth            E-Mail Address                                     

First Name                                      Middle                        Last Name

Residence Address (No PO Box allowed)                                     Time at Residence

                                                                                                           Yrs.             Mos.

City                                                              State                                      Zip

Home Phone Number                 Cell Phone Number                      Work Phone Number

             /                /                            /                /                                 /                /

Present Employer             Occupation                     Gross Monthly Salary   Length of Employment

                                                                              $                                           Yrs.       Mos.

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 this obligation.

Other Income                     Source                                               Monthly Amount

$                                                                                                $

By signing this application: 1) you warrant all information you provide is true and complete; 2) you authorize 

Dealer to assign this application to Aqua Finance, Inc. or its assigns; 3) you authorize a full investigation 

and release of any records from any source, including credit bureau reports, to check the accuracy of 

information on this application  ; and 4) you consent to receiving autodialed message calls from us or our 

agents on your wireless phone. You have a continuing duty to keep us informed if any information on this 

application changes. By completing and signing this application you understand that you have requested 

that  we  open  a  revolving  credit  account  which  allows  you  to  make  credit  purchases  on  account  as 

evidenced by a revolving credit sales slip, and you agree to all the terms and conditions of this Revolving 

Credit Agreement. By your signature you acknowledge that you have received and read all the terms of 

this Agreement before making any purchases on the account.

AFI-550-RCA  2-15-2014 home improvement   176307

Applicant Signature                                                                             Date

                                                                                                                        /           /

Applicant Drivers Lic. No.                              State                                 Expiration Date

                                                                                                                        /           /

Joint Applicant Signature                                                                    Date

                                                                                                                        /           /

Joint Applicant Drivers Lic. No.                     State                                   Expiration Date

NOTICE  TO  WISCONSIN  APPLICANTS:  No  provision  of  a  marital  property  agreement,  a  unilateral 

statement under Wis. Stats. §766.59, or a court decree under Wis. Stats. §766.70 adversely affect the 

interest of the creditor unless the creditor is furnished a copy of the decree, agreement, statement, or has 

actual knowledge of the adverse provision prior to the time credit is granted. You must supply us with your 

spouse’s name and address in the Spouse/Joint Applicant section above so we can give notice of this 

credit transaction by mailing a copy of this application.  If you are married, you agree that this obligation is 

incurred in the interest of marriage or family. 

Applicant Signature:___________________________________________________________________

CREDIT REPORT NOTICE: We may request a credit report for any legitimate purpose associated with 

your application for credit, extending credit, modifying the terms of your credit agreement, or collection on 

your account. On your request we will inform you if such a report was ordered and will give you the name 

and address of the credit reporting agency that furnished the report.

NOTICE: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit 

applicants  on  the  basis  of  race,  color,  religion,  national  origin,  sex,  marital  status,  age  (provided  the 

applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income 

derives from any public assistance program; or because the applicant has in good faith exercised any right 

under the Consumer Credit Protection Act.  The Federal agency that administers compliance with the law 

concerning this creditor is the Federal Trade Commission.

Delaware residents: Service charges not in excess of those permitted by law will be charged on 

the outstanding balances from month to month.

Maryland residents: Finance charges will be made in amounts or at rates not in excess of those 

ASSIGNMENT: Should Aqua Finance, Inc. (“AFI”) acquire your account as a result of your credit application, 

AFI may further assign your credit transaction to a credit union which may require you to be a member.  In 

that event, and by signing this application, you agree to the terms of membership as set forth below:

I apply for membership in and agree to the terms and conditions as provided, and I agree to conform to 

the  bylaws  and  any  amendments  of  any  credit  union  which  accepts  assignment  of  my  credit  transaction.  

I  authorize  the  credit  union  to  check  my  account,  credit,  and  employment  history,  and  to  obtain  a  credit 

report now or in the future.  I understand that this will assist the credit union, for example, in determining my 

initial and ongoing eligibility for my/our Account and/or in connection with making future credit opportunities 

available to me.  This is not a marital account.  If the initial share is deposited by the credit union, it will be 

revoked if no additional deposits or loans are added to my membership within one year of membership date.  

It is agreed that if more than one person signs this application, this account is jointly held by the parties named 

hereon.  Upon the death of any of them, ownership or all funds in this account are passed to the survivor.

AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTS

 I hereby authorize the initiation of a periodic deduction from my account at the financial institution 

named  below  through  the  ACH  system  and  authorize  said  institution  to  debit  my  account  for  the 

amount and at the frequency set forth below.  I acknowledge that this request does not violate the 

provisions of United States law as it applies to ACH transactions.  I understand I have a right to stop 

this automatic payment by notifying either the institution named below or AFI, in writing, at least three 

(3) business days prior to the day my account is scheduled to be charged and that there may be a fee 

for that service.  Further I agree that AFI will require written confirmation of an oral stop-payment order 

within fourteen (14) days.  This will be a permanent stop payment on this preauthorized payment.  I 

may, however, establish a new preauthorized payment from the same financial institution or company 

in the future.  I also authorize adjustment entries in the event of erroneous transactions on my account.  

I agree to hold AFI harmless for any expenses, including fees, incurred as a result of its inability to 

process a scheduled preauthorized withdrawal due to:  my having supplied incorrect information, its 

having acted on a stop payment order, or there being insufficient funds in the account I have indicated.

Bank Name  _____________________________________________________________________

Bank Address  ___________________________________________________________________

IMPORTANT: PLEASE ATTACH A VOIDED CHECK WITH CORRECT ENCODING INFORMATION

Bank Routing Number_____________________ Depositor Account Number _______________

Type of Account: 

 Checking 

 Savings

X_____________________________________   X ______________________________________

Signature of Depositor                                       (if joint account, both must sign)

 I would like to receive my monthly account statements by email and have access to pay my bill online.  

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IMPORTANT INFORMATION ABOUT YOUR ACCOUNT

KEEP THIS INFORMATION FOR YOUR RECORD

REVOLVING CREDIT AGREEMENT AND DISCLOSURE STATEMENT

Dealer  may  assign  all  rights  under  this  Agreement  and  any  credit  sale  made  pursuant  to  it  (as 

evidenced by a revolving credit sales slip) to Aqua Finance, Inc. (“AFI”) and to AFI’s further assigns.

17.99% All other states 

***Not all offers will contain introductory rates. If not otherwise specified 

on Revolving Credit Sales Slip or Promo Addendum, then your APR is the 

maximum non-introductory state APR in table, below.  

Interest Rates and Interest Charges

Annual Percentage Rate 

(APR) for Purchases 

Penalty APR and 

When it Applies**

Paying Interest 

Introductory rates between 0% and

9.9%, ranging from 6 months to 12 

months.***  Non-introductory rates

between 5.9% and 17.99%.

All rates are based on the specific 

promotion or your credit worthiness, and 

dealer participation. (Maximum APR 

Varies By State. See table below *)

21%  (see table below for 

applicability in your state**)

This APR may be applied to your 

account if you make a late payment.  

How Long Will the Penalty Rate 

Apply?:  The Penalty APR may 

remain in effect indefinitely.

Interest Charges begin on the date a 

purchase is posted to your account, 

except in states requiring a grace 

period, in which case your due date 

is at least 25 days after the close 

of each billing cycle and we will not 

charge you interest if you pay your 

entire balance by the due date.

when  applying  for  or  using  a  credit 

card,  visit  the  Consumer  Financial 

Protection Bureau’s website at

http://www.consumerfinance.gov/

learnmore.

Fees Vary By State

Up to $35 See Paragraph 11 of Agreement

Up to $35 See Paragraph 12 of Agreement

Minimum Interest Charge

If you are charged interest, the charge 

will be no less than $0.50.

For Credit Card Tips from 

To learn more about factors to consider 

the Consumer Financial 

Protection Bureau 

Fees 

Penalty  Fees

(cid:127) Late Payment 

(cid:127) Returned Payment 

details.

How  We  Will  Calculate  Your  Balance:  We  use  a  method  called  the  “Daily 

Balance  (including  new  purchases).”    See  your  account  Agreement  for  more 

fund transfer from your account.

Loss of Introductory APR: We may end your introductory APR and apply the 

Penalty APR if you make a late payment.

Billing  Rights:  Information  on  your  rights  to  dispute  transactions  and  how  to 

exercise those rights is provided in your account agreement.

This  information  is  accurate  on  the  date  of  your  application  and  initial 

purchase.  If any of this information changes you will be notified at least 45 

days prior to any change and how to contact us regarding any change.  All 

*Maximum Non-Introductory State  APR  Rates

12.00% Connecticut

14.40% Michigan

14.76% Pennsylvania 17.00% Arkansas

** The penalty APR rate does not apply in the following states: Arkansas, Colorado, Connecticut, 

Delaware,  Florida,  Illinois,  Kansas,  Louisiana,  Maine,  Maryland,  Massachusetts,  Michigan, 

Minnesota,  Nebraska,  North  Carolina,  Oklahoma,  Pennsylvania,  Rhode  Island,  South  Carolina, 

Texas, and Wyoming.

1. GENERAL:  If your credit application is approved and we open a revolving credit account for you, 
you may purchase household goods and services on credit from the dealer where you opened your 
account. Purchases are pursuant to a revolving credit sales slip and you agree that all sales are subject 

to the terms of this Agreement. 

2.  PROMISE  TO  PAY:    You  agree  to  pay  for  all  purchases  made  on  your  account,  INTEREST 
CHARGES,  and  other  applicable  charges  or  fees  under  this  Agreement  incurred  by  you  or  anyone 
you authorize or permit to use your account. If this account is a joint account, each joint account holder 
agrees to pay, and all account holders are jointly and severally responsible for all amounts owed on 
the account. If your account is referred for collections to an attorney who is not our salaried employee, 
you agree to pay reasonable attorney fees and reasonable collection costs to the extent allowed by 
law in your state. If your state does not allow attorney fees (IA, ME, OH, and WI), you agree to pay any 

statutory attorney fees and costs that may be awarded to us by a court of law. 

3. CREDIT LIMIT:  We set a credit limit on your account which we may modify at any time for any reason 
not prohibited by law. You may not charge purchases if it causes you to exceed your credit limit unless 

we allow such purchases. You agree to pay all amounts over your credit limit.

4. BILLING STATEMENT:  We will mail you a statement each month you have an account balance 
greater than $1.00 at the address we have in our records. This statement will show credit purchases, 
late  charges,  NSF  fees,  previous  balance,  new  balance,  payments  received,  credits,  INTEREST 

CHARGES, total minimum payment due, and payment due date.

5.  MINIMUM  MONTHLY  PAYMENT:    All  payments,  except  disputed  payments,  must  be  mailed  or 
delivered  to  the  Payment  Processing  Center  address  shown  on  your  monthly  billing  statement.  All 
payments must be made by electronic fund transfer, check or money order. Do not send cash. Cash or 
other nonconforming methods of payment may be rejected. We may accept partial or late payments or 
checks marked “payment in full” or other restrictive endorsement without losing our right to receive the 
full amount owed. Your billing statement will include requirements for you to follow in making payments. 
Disputed payments, including those which indicate that the payment constitutes “payment in full” of the 
amount owed, must be mailed or delivered to the Customer Service address listed below. You agree 
to pay us at least the Total Minimum Monthly Payment reflected on your statement. You may pay more 
than the Total Minimum Monthly Payment and you may pay the entire amount due at any time. The 
Total Minimum Monthly Payment Due shown on your billing statement will be the sum of the Minimum 
Monthly  Payment  plus  all  past  due  amounts,  late  fees,  and  other  charges.    The  Minimum  Monthly 
Payment is calculated at the end of the first month in which you make a purchase, and will be calculated 
each  month  in  which  you  make  an  additional  purchase.    Your  Minimum  Monthly  Payments  will  be 
between  2%  and  5%  of  the  “Highest  Monthly  Charge”  balance  since  your  Monthly  Charge  Balance 
was zero (or if you participate in specified Promotion Plans, Your Minimum Monthly Payments will be 
between 1% and 2% of the “Highest Monthly Charge” balance since your Monthly Charge Balance was 
zero), less any Special Payment Plans as shown on your billing statement rounded to the next higher 
dollar, or $15, whichever is greater, unless your account balance is less than $15 in which case the 
Minimum Monthly Payment will be equal to the account balance. You agree that any payment may 
be returned if your check is (i) not drawn in U.S. dollars on funds on deposit in the U.S.; (ii) missing a 
signature; (iii) drawn with different numeric and written amounts; (iv) contains a restrictive endorsement; 
(v) postdated; or (vi) not paid on presentment.  If you do not make a Total Minimum Monthly Payment 
within 60 days of its due date, we may apply the Penalty APR to your account, if allowed by the state of 
your residence.  We will give you advanced notice of the date the Penalty APR is effective.  The Penalty 
APR may remain in effect indefinitely, unless you make the first six consecutive Total Minimum Monthly 
Payments when due following the effective date of the application of the Penalty APR to your account.
6.  ELECTRONIC  FUND  TRANSFER:    When  you  provide  a  check,  you  authorize  us  either  to  use 
information from your check to make a one-time electronic fund transfer from your account or to process 
the transaction as a check.  When we use your check to make an electronic fund transfer, funds may 
be withdrawn from your account as soon as the same day we receive your payment, and you may not 
receive your check back from your financial institution. If there are insufficient funds in your account you 
authorize us to charge an NSF Fee as indicated below and collect that amount through an electronic 

7. PREPAYMENT:  You may pay your entire account balance at any time without penalty.  If you do 
not pay the entire balance in full, you must make a minimum payment each month by the payment 
due date that appears on your billing statement. Under federal law, we are not required to refund any 

amounts less than $1.00.

8. INTEREST CHARGE:  INTEREST CHARGES begin the date a purchase is posted to your account 
and accrue as long as your account has a balance, except in states with a mandatory grace period.  
The INTEREST CHARGE is computed by applying a daily periodic rate of between 0% and .02712% 
(corresponding to an APR of 9.9%) for an Introductory APR, or between .01616% (corresponding to 
an APR of 5.9%) and .04929% (corresponding to an APR of 17.99%) for a Non-Introductory APR, to 
the daily balance.  The daily balance is calculated by taking the beginning balance in the account each 
day, adding any new purchases and subtracting any unpaid interest or other finance charges and any 
payments  and  credits.    The  INTEREST  CHARGE  is  calculated  by  (i)  taking  each  daily  balance,  (ii) 
multiplying  that  daily  balance  by  the  applicable  daily  periodic  rate,  (iii)  adding  together  the  resulting 
amounts for each day in the billing cycle. The total periodic INTEREST CHARGES for the billing cycle 
is the sum of the periodic INTEREST CHARGES for each purchase type rounded to the next highest 
cent.  Any Daily Balance less than zero will be treated as zero. A minimum INTEREST CHARGE of no 
less than $0.50 is added to your account in any billing cycle your account is subject to an INTEREST 
CHARGE, except in states where prohibited by law. The grace period is 25 days in Louisiana, Maine, 
Maryland, Massachusetts, Mississippi, North Carolina, and Virginia and 30 days in Nebraska & Vermont 
on new purchases where your account balance is $0 or you have paid your previous balance due in 

full by the end of the billing cycle. 

Monthly Payment______________________  Monthly Withdrawal Start Date______________________

terms are subject to change. 

9.  DEFAULT:    You  are  in  default  if:  (a)  you  fail  to  make  a  required  payment  when  due  on  two 
occasions in any 12 month period; (b) you fail to observe or perform any of the other covenants or 
duties contained in this Agreement if the failure materially impairs the condition, value or protection 
of  our  right  in  any  Collateral,  or  materially  impairs  your  ability  to  pay  any  amounts  on  your  billing 
statement when due. You will receive a Notice of Right to Cure in the following states: Colorado, Iowa, 
Kansas, Maine, Massachusetts, Nebraska, Pennsylvania, and Wisconsin. If you fail to cure within the 
time allowed in your notice or within 30 days if you live in a state with no notice requirement, we may 
accelerate your balance.
10. SPECIAL CREDIT PROMOTION PLANS: We may occasionally offer special credit promotion 
plans for you to participate in at your option.
11. LATE FEE:  If your payment is more than 10 days late (15 days in ME, MA or SD and 30 days 
in NC), you may be charged a late fee up to the amount indicated below for your state of residence.  
The late fee will be added to your account balance.

$5
$10
$15
$25

5% of payment due;  $35 maximum*

KS & MO if payment due is less than $25
AK, AR, CA, FL, KS, MO, MT, NJ, NC, OH, RI, SD, TN  
CO, IN, IA, MS, NV, NH, NY, ND, OR, VT, WA, WI
GA
MN -$7.80 maximum                           5% of payment due
KY & WY ($10 minimum);
AL, ID & MI ($15 minimum);
HI, NE, VA
UT
OK ($5 minimum)
TX, D.C.
AZ, CT, IL, LA, MD, ME, PA
NM, SC
MA
*($25 maximum-first occurrence in more than 6 months.)
12.  RETURNED  PAYMENT  /  NSF  FEE:    If  any  payment  instrument  or  method  is  dishonored  by 
your bank or the drawee, you agree to pay an NSF fee up to the amount indicated below for your 
state of residence.  No NSF fee will be charged if your state of residence is DE, MD, NE or WY.  If 
required by your state, you will receive a notice with instructions about the NSF service or collection 
fees, and if you fail to pay the fee we will add it to your account balance.  We are not required to 
present payment instruments more than once to the drawee for payment. This fee will be added to 
your account balance. 

5% of payment due; $30 maximum*
5% of payment due; $20 maximum
5% of payment due; $15 maximum
5% of payment due; $10 maximum
5% of payment due; $5 maximum
10% of payment due; $10 maximum

MA, ME, AZ (greater of $10 or bank fee)
CA, MS, MO
CT, D.C., ID, IA, NY, OH, PA, UT, VT
AR, CO, FL, IL, IN, KY, LA, MI, MN, NV, NH, NM, NC, OK, OR, RI, TX, WI 
AL, AK, GA, HI, KS, MT, SC, SD, TN
ND, VA, WA
*($25 maximum-first occurrence in more than 6 months.)
13. ACCOUNT INFORMATION:  You authorize us to furnish information about your account to credit 
reporting  agencies  and  anyone  else  who  may  lawfully  receive  such  information.  On  request,  you 
agree to promptly provide us with accurate and updated financial and employment information. You 
agree to give us prompt notice of any change in your name, address, and telephone numbers. Where 
allowed by law, you authorize the Department of Motor Vehicles to release your address if it becomes 
necessary to locate you.

$10
$15
$20
$25
$30*
$35*

14. CHANGE IN TERMS:  We may change the terms of this Agreement, as permitted by law, at any 
time. You will be notified of changes in accordance with applicable state and federal law, but in the 
event your state does not specify a time period, you will be notified at least 45 days in advance of any 
such changes, and such notice will be sent to your current address as shown on our records for your 
account. We count the days from the date we mail the notification. 

15. CREDIT INVESTIGATION:  You agree we may investigate your credit, employment, and financial 
status. You authorize us to obtain a credit report and any other information about your creditworthiness 
in connection with processing your application for credit, and subsequently in connection with any 
extension of credit, request to increase credit limits, or any renewal or update of your account, or to 
take collection action on the account, or to investigate disputes regarding the account. At your request, 
we will inform you if such reports were ordered, and the names of the credit bureaus that provided 
reports.  You  authorize the Department of Defense and its various departments and commands to 
verify your social security number or other identifier and disclose your home address to the authorized 
holder of this Agreement for purposes of performing or enforcing the terms of this Agreement. You 
authorize any past or present employer to confirm employment or communicate with us regarding your 
indebtedness to us if you fail to meet the terms and conditions of this Agreement. We use information 
furnished solely in connection with performing or enforcing the terms of this Agreement. 
16. ACCOUNT CANCELLATION:  We may cancel your account at any time for any reason subject to 
the requirements of applicable law. Outstanding balances continue to accrue INTEREST CHARGES 
until paid in full, and remain subject to all terms and conditions of this Agreement. You may cancel 
your account by writing to our account service provider Aqua Finance, Inc., P.O. Box 844, Wausau, 
WI 54402-0844. Your notice is effective on receipt. If you cancel your Account, you are still responsible 
for all amounts owed pursuant to the terms of this Agreement. 

17.  ASSIGNMENT:    This  Agreement  is  not  effective  until  your  application  has  been  approved  by 
AFI. We have the right to assign any or all of our rights under this Agreement to any assignee of our 
choosing.  You may not assign this Agreement or any rights under it and any attempt to make such 
an assignment will be null and void. You understand that Dealer and AFI are independent entities and 
not employees or agents of one another. This Agreement legally binds the parties and their respective 
heirs, representatives, executors, administrators, successors and assigns.  

18. SEVERABILITY:  If any provision of this Agreement is deemed void or unenforceable under any 
law, rule, or regulation, all other provisions remain in effect and enforceable. 
19.  NON-WAIVER:  We do not lose any of our rights under this Agreement if we delay taking action 
for any reasons.

20. REPRESENTATION:  You swear that all the information you supplied on your credit application 
and all the information on each revolving credit sales slip is and will be true, correct, and accurate. 
Any false, incorrect, or misleading information you knowingly supply is a deliberate misrepresentation. 

NOTICE  TO  BUYER:  1)  DO  NOT  SIGN  ANY  PART  OF  YOUR  REVOLVING 

CREDIT AGREEMENT BEFORE YOU READ IT OR IF IT CONTAINS ANY BLANK 

SPACES.  2)  YOU  ARE  ENTITLED  TO  A  COMPLETELY  FILLED  IN  COPY  OF 

ANY  AGREEMENT  WHEN  YOU  SIGN  IT.  3)  A  FINANCE  CHARGE  WILL  BE 

COMPUTED  ON  THE  OUTSTANDING  BALANCE  EACH  BILLING  PERIOD  IN 

ACCORDANCE  WITH  THE  RATES  ABOVE.  4)  YOU  MAY  PAY  YOUR  TOTAL 

UNPAID BALANCE AT ANY TIME.

Dealer Name:_______________________________________________________ 

Address:  __________________________________________________________

AFI-550-RCA 2-15-2014 home improvement   176307

Revolving Credit

Home Improvement

21.  STATE LAW RESIDENT NOTICES:
CALIFORNIA STATE NOTICE: Applicants may 1) use the credit account up to 
its credit limit after credit approval; 2) be liable for amounts extended under the 
plan to any joint applicant. A negative credit report reflecting on your credit record 
may be submitted to a credit reporting agency if you fail to fulfill the terms of your 
credit obligations.
COLORADO RESIDENTS: Warning: The terms of this revolving charge account may be changed, 
whether or not authorized by agreement, in accordance with the Colorado UCCC and other applicable 
law.
DELAWARE:  Service  charges  not  in  excess  of  those  permitted  by  law  will  be  charged  on  the 
outstanding balances from month to month.
DISTRICT OF COLUMBIA: Seller certifies that the information contained in the contract complies with 
the District of Columbia Municipal Regulations, Title 16, Chapter 1.
ILLINOIS: No applicant may be denied a credit card on account of race, color, religion, national origin, 
ancestry, age (between 40 and 70), sex, marital status, physical or mental handicap unrelated to the 
ability to pay or unfavorable discharge from military service. The applicant may request the reason 
for rejection of his or her application for a credit card. No person need reapply for a credit card solely 
because of a change in marital status unless the change in marital status has caused deterioration in 
the person’s financial position. A person may hold a credit card in any name permitted by law that he 
or she regularly uses and is generally known by, so long as no fraud is intended thereby.
MAINE: We may request a consumer report in connection with your application for credit. You may 
ask whether a consumer report was obtained by us and we will tell you the name and address of the 
consumer reporting agency, if a report was obtained. Charges incurred by use of your card are due 
and payable on receipt of your monthly statement.
MARYLAND: Finance charges will be made in amounts or at rates not in excess of those permitted by 
law. You may pay the entire balance at any time without incurring additional charges for prepayment. 
NEW HAMPSHIRE: Consumer or Consumer’s attorney may file a 
complaint with the New Hampshire Commissioner of Banking.
VERMONT: We may obtain your credit reports at any time, for any legitimate purpose associated 
with the account or the application or request for an account, including but not limited to reviewing, 
modifying, renewing and collecting on your account. On your request we will inform you if such a 
report was ordered. If so, we will give you the name and address of the consumer reporting agency 
furnishing the report. 
OHIO:  Ohio  anti-discrimination  laws  require  creditors  to  make  credit  equally  available  to  all  credit 
worthy customers and that credit reporting agencies maintain separate credit histories on individuals 
upon request. The Ohio Civil Rights Commission administers these laws.
TEXAS: To contact Aqua Finance, Inc. about this account call 715-848-5425.  This contract is subject 
in whole or in part to Texas law which is enforced by the Consumer Credit Commissioner, 2601 N. 
Lamar Blvd., Austin, Texas 78705. Phone 512-936-7600. Contact the commissioner relative to any 
inquiries or complaints. 
22.   SECURITY AGREEMENT: You grant us a purchase money security interest under the Uniform 
Commercial  Code  in  each  household  good  purchased  on  account  to  the  full  extent  permitted  by 
law.  To the extent allowed by law, you will pay all official fees and taxes, and on request, take any 
reasonable  action  requested  by  us  to  preserve  the  collateral  or  to  establish,  determine  priority  of, 
perfect, continue perfected, terminate or enforce our interest in it or rights under this agreement. If 
you do not make payments as agreed, this security interest allows us to take actions in accordance 
with  state  laws  governing  the  enforcement  of  security  interests  in  collateral.  You  further  agree  to 
keep the goods installed at the address on the credit application and to not remove or materially alter 
them without our written consent. You may lose the goods you purchased if you do not meet your 
obligations under this agreement.
23.  NOTICE:

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 TO THIS AGREEMENT OR WITH THE PROCEEDS FROM IT.  
DEBTOR’S RECOVERY UNDER THIS AGREEMENT MAY NOT EXCEED 
THE AMOUNT OF CREDIT OUTSTANDING. 
Arizona residents - You must give us notice of your claim or defense in writing by certified mail within 
90 days of receiving any goods or you may waive the right to set-offs or defense against assignee 
if assignee provides you a notice of your rights and you fail to exercise those rights pursuant to the 
terms of the notice.   Iowa residents - You must give assignee notice within 30 days of assignment to 
assert claims and defenses against assignee.   Oklahoma & South Dakota residents - You waive 
the right to bring a claim or defense against assignee if assignee provides you a notice of your rights 
and you fail to exercise those rights pursuant to the terms of the notice.   Wisconsin residents - You 
waive the right to bring a claim or defense against assignee after 12 months if assignee provides you 
a notice of your rights to do so and you fail to exercise those rights pursuant to the terms of the notice 
of assignment.  This waiver is in accordance with section 422.407 (4) of the Wisconsin Consumer Act.   
Wyoming residents - You waive the right to bring a claim or defense against assignee for 45 days 
after assignment if assignee provides you a notice of your rights and you fail to exercise those rights 
pursuant to the terms of the notice.
24.  CUSTOMER SERVICE:  Direct all inquiries concerning your account to:
    Aqua Finance, Inc.
P.O. Box 844
Wausau, WI 54402-0844

or call Customer Service at telephone number 800-234-3663.
25.  BILLING RIGHTS NOTICE:
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.

AFI-550-RCA  2-15-2014 home improvement   176307

What To Do If You Find A Mistake On Your Statement  
If you think there is an error on your statement write us at:  

If all of the criteria above are met and you are still dissatisfied with the purchase, 

contact us in writing at:

     Aqua Finance, Inc.  

     ATTN: Customer Billing

     One Corporate Drive, Suite 300 

     Wausau, WI 54401

Aqua Finance, Inc.  

ATTN: Customer Billing

One Corporate Drive, Suite 300 

Wausau, WI 54401

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 

full amount due.

you want to stop payment on the amount you think is wrong.

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.

Note to all Buyers: Finance Charges will be made in amounts or at rates not 

in excess of those permitted by law. You have the right to pay in advance the 

You must notify us of any potential errors in writing. 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:
•  We cannot try to collect the amount in question, or report you as delinquent on 

that amount.  

•  The charge in question may remain on your statement, and we may continue to 

charge you interest 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 did 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 may 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 the rules above, we cannot collect the first $50 of the amount you 
questioned amount, even if your bill was 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 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.

Revised 2/15/14

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
21.  STATE LAW RESIDENT NOTICES:

CALIFORNIA STATE NOTICE: Applicants may 1) use the credit account up to 
its credit limit after credit approval; 2) be liable for amounts extended under the 
plan to any joint applicant. A negative credit report reflecting on your credit record 
may be submitted to a credit reporting agency if you fail to fulfill the terms of your 

credit obligations.

law.

COLORADO RESIDENTS: Warning: The terms of this revolving charge account may be changed, 
whether or not authorized by agreement, in accordance with the Colorado UCCC and other applicable 

DELAWARE:  Service  charges  not  in  excess  of  those  permitted  by  law  will  be  charged  on  the 

outstanding balances from month to month.

DISTRICT OF COLUMBIA: Seller certifies that the information contained in the contract complies with 

the District of Columbia Municipal Regulations, Title 16, Chapter 1.

ILLINOIS: No applicant may be denied a credit card on account of race, color, religion, national origin, 
ancestry, age (between 40 and 70), sex, marital status, physical or mental handicap unrelated to the 
ability to pay or unfavorable discharge from military service. The applicant may request the reason 
for rejection of his or her application for a credit card. No person need reapply for a credit card solely 
because of a change in marital status unless the change in marital status has caused deterioration in 
the person’s financial position. A person may hold a credit card in any name permitted by law that he 

or she regularly uses and is generally known by, so long as no fraud is intended thereby.

MAINE: We may request a consumer report in connection with your application for credit. You may 
ask whether a consumer report was obtained by us and we will tell you the name and address of the 
consumer reporting agency, if a report was obtained. Charges incurred by use of your card are due 

and payable on receipt of your monthly statement.

MARYLAND: Finance charges will be made in amounts or at rates not in excess of those permitted by 
law. You may pay the entire balance at any time without incurring additional charges for prepayment. 
NEW HAMPSHIRE: Consumer or Consumer’s attorney may file a 

complaint with the New Hampshire Commissioner of Banking.

VERMONT: We may obtain your credit reports at any time, for any legitimate purpose associated 
with the account or the application or request for an account, including but not limited to reviewing, 
modifying, renewing and collecting on your account. On your request we will inform you if such a 
report was ordered. If so, we will give you the name and address of the consumer reporting agency 

furnishing the report. 

OHIO:  Ohio  anti-discrimination  laws  require  creditors  to  make  credit  equally  available  to  all  credit 
worthy customers and that credit reporting agencies maintain separate credit histories on individuals 

upon request. The Ohio Civil Rights Commission administers these laws.

TEXAS: To contact Aqua Finance, Inc. about this account call 715-848-5425.  This contract is subject 
in whole or in part to Texas law which is enforced by the Consumer Credit Commissioner, 2601 N. 
Lamar Blvd., Austin, Texas 78705. Phone 512-936-7600. Contact the commissioner relative to any 

inquiries or complaints. 

22.   SECURITY AGREEMENT: You grant us a purchase money security interest under the Uniform 
Commercial  Code  in  each  household  good  purchased  on  account  to  the  full  extent  permitted  by 
law.  To the extent allowed by law, you will pay all official fees and taxes, and on request, take any 
reasonable  action  requested  by  us  to  preserve  the  collateral  or  to  establish,  determine  priority  of, 
perfect, continue perfected, terminate or enforce our interest in it or rights under this agreement. If 
you do not make payments as agreed, this security interest allows us to take actions in accordance 
with  state  laws  governing  the  enforcement  of  security  interests  in  collateral.  You  further  agree  to 
keep the goods installed at the address on the credit application and to not remove or materially alter 
them without our written consent. You may lose the goods you purchased if you do not meet your 

obligations under this agreement.

23.  NOTICE:

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 TO THIS AGREEMENT OR WITH THE PROCEEDS FROM IT.  

DEBTOR’S RECOVERY UNDER THIS AGREEMENT MAY NOT EXCEED 

THE AMOUNT OF CREDIT OUTSTANDING. 

Arizona residents - You must give us notice of your claim or defense in writing by certified mail within 
90 days of receiving any goods or you may waive the right to set-offs or defense against assignee 
if assignee provides you a notice of your rights and you fail to exercise those rights pursuant to the 
terms of the notice.   Iowa residents - You must give assignee notice within 30 days of assignment to 
assert claims and defenses against assignee.   Oklahoma & South Dakota residents - You waive 
the right to bring a claim or defense against assignee if assignee provides you a notice of your rights 
and you fail to exercise those rights pursuant to the terms of the notice.   Wisconsin residents - You 
waive the right to bring a claim or defense against assignee after 12 months if assignee provides you 
a notice of your rights to do so and you fail to exercise those rights pursuant to the terms of the notice 
of assignment.  This waiver is in accordance with section 422.407 (4) of the Wisconsin Consumer Act.   
Wyoming residents - You waive the right to bring a claim or defense against assignee for 45 days 
after assignment if assignee provides you a notice of your rights and you fail to exercise those rights 

24.  CUSTOMER SERVICE:  Direct all inquiries concerning your account to:

pursuant to the terms of the notice.

    Aqua Finance, Inc.

P.O. Box 844

Wausau, WI 54402-0844

or call Customer Service at telephone number 800-234-3663.

25.  BILLING RIGHTS NOTICE:

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 us at:  

If all of the criteria above are met and you are still dissatisfied with the purchase, 
contact us in writing at:

     Aqua Finance, Inc.  
     ATTN: Customer Billing
     One Corporate Drive, Suite 300 
     Wausau, WI 54401

Aqua Finance, Inc.  
ATTN: Customer Billing
One Corporate Drive, Suite 300 
Wausau, WI 54401

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. 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:
•  We cannot try to collect the amount in question, or report you as delinquent on 

that amount.  

•  The charge in question may remain on your statement, and we may continue to 

charge you interest 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.

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.

Note to all Buyers: Finance Charges will be made in amounts or at rates not 
in excess of those permitted by law. You have the right to pay in advance the 
full amount due.

NOTICE  TO  BUYER:  1)  DO  NOT  SIGN  ANY  PART  OF  YOUR  REVOLVING 
CREDIT AGREEMENT BEFORE YOU READ IT OR IF IT CONTAINS ANY BLANK 
SPACES.  2)  YOU  ARE  ENTITLED  TO  A  COMPLETELY  FILLED  IN  COPY  OF 
ANY  AGREEMENT  WHEN  YOU  SIGN  IT.  3)  A  FINANCE  CHARGE  WILL  BE 
COMPUTED  ON  THE  OUTSTANDING  BALANCE  EACH  BILLING  PERIOD  IN 
ACCORDANCE  WITH  THE  RATES  ABOVE.  4)  YOU  MAY  PAY  YOUR  TOTAL 
UNPAID BALANCE AT ANY TIME.

Dealer Name:_______________________________________________________ 

Address:  __________________________________________________________

AFI-550-RCA 2-15-2014 home improvement   176307

Revolving Credit

Home Improvement

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 did 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 may 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 the rules above, we cannot collect the first $50 of the amount you 
questioned amount, even if your bill was 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 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.

AFI-550-RCA  2-15-2014 home improvement   176307

Revised 2/15/14