SECURED CREDIT CARD APPLICATION 

Secured Platinum Rewards MasterCard
Earn points each time you use our Secured Platinum Rewards MasterCard.  You can redeem those points for cash, travel, merchandise, 
event 
on  our Rewards Plus list. And don’t forget the 1,000 bonus points you get with your first purchase. It also features an introductory rate as 
low as 0%  APR and no balance transfer fees.  Visit  www.selectyourrewards.com/UICCU and select “browse only” for details. 

tickets and much more. You’ll earn at least one point for each dollar of purchase, or considerably more if shopping with a merchant 

If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit.

Credit line requested $ 

 ($500 minimum) 

Applicant information (Please print clearly. All information is required to process.) 
Are you a citizen or permanent resident of the United States? 

Yes    No 

Name 

(as you wish it to appear on the card) 

Date of Birth 

Social Security # 

Mother’s Maiden Name 

Street Address 

How Long at Address 

Home Phone 

UICCU Member Number 

_ 

City 

Employer 

$ 
Gross Annual Income 

Name: 

Name: 

State 

ZIP 

Cell Phone 

Email Address 

Date Employed 

Work Phone 

Do You  ∆ Own  ∆ Rent 
Payment $  

$  
Other Gross Annual Income (Alimony, child support, or separate maintenance income need not be revealed if you 
do not wish to have it considered as a basis for repaying the obligation). 

City/State: 

Phone Number 

_ 

City/State: 
REQUIRED:  Please list the information of the nearest relatives not living with you. 

Phone Number  

Co-applicant information (Please print clearly.) 

Name 

(as you wish it to appear on the card) 

Date of Birth 

Social Security # 

Mother’s Maiden Name 

Street Add ress 

How Long at Address 

Home Phone 

UICCU Member Number 

_ 

City 

Employer 

$ 
Gross Annual Income 

State 

ZIP 

Cell Phone 

Email Address 

Date Employed 

Work Phone 

Do You  ∆ Own  ∆ Rent 
Payment $  

$  
Other Gross Annual Income (Alimony, child support, or separate maintenance income need not be revealed if you 
do not wish to have it considered as a basis for repaying the obligation). 

Introductory Annual 
Percentage Rate (APR) for 
Purchases, Balance 
Transfers  and Cash 
Advances 

APR for purchases, Balance 
Transfers and Cash 
Advances 

How to Avoid Paying 
Interest  on Purchases 

Minimum Finance Charge 

For Credit Card Tips from 
the  Consumer Financial 
Protection  Bureau 

Interest Rates and Interest Charges 

A fixed Introductory rate of 0%-11.9%* shall apply for the first six months.  Thereafter, 
the APR for all outstanding indebtedness and  new balances relating to purchase transactions 
shall be at the rate listed below.

11.9 – 18.9%* 

Non- Variable Rate 
*Your APR is dependent on your Credit  Worthiness 

Your due date is at least 25 days after the close of each billing cycle.  We will not charge you 
any interest on purchases if you pay your entire balance  by the due date each month.  We will 
begin charging interest on cash advances and balance transfers on the transaction date. 

None 

To learn more about factors to consider when applying for or using a credit card, visit 
the website of the Consumer Financial Protection  Bureau at 
www.consumerfinance.gov/learnmore. 

Fees 
Annual Fee 

None 

Transaction Fees 
1.

Internal Balance
Transfer  Fees 
External 
Balance 
Transfers 
Fees 
Convenience Check Fees 
Cash Advance Fees 
Foreign Transaction Fees 

2.

3.
4.
5.

1.
2.
3.
4.
5.

None 
None 
None 
Either $5, or 3% of the amount of  each cash advance, whichever is  greater 
1% of each foreign transaction in U.S. dollars 

Penalty Fees 
•
•
•

Late Payment Fee 
Over-the-Credit Limit Fee 
Returned Check Fee 

•
•
•

Up to $15 
None 
Up to $25 

•
•

•
•

How We Will Calculate Your Interest:  We use a method called “average daily balance (including new purchases).”  See your cardholder agreement for more details. 
Payments:  The minimum monthly payment is 2% of the new balance, or $25.00, whichever is greater.  If the unpaid interest and fees on the account are greater than the 
minimum monthly payment, the minimum monthly payment will become that amount.  Any amount that is past due or prior minimum payments that were not made will also be
added to the minimum monthly payment amount. 
Loss of Introductory APR: You will lose your Introductory APR if your account becomes delinquent or over the limit. 
This information is accurate as of 9/01/2015. 

PLEDGE OF SHARES.  You grant us a security interest in any of your share accounts with us to secure payment of your Account.  You authorize us to apply any funds in your 

share accounts to the balance owing on your Account if you should default.

1. You promise that everything you have stated in this application is correct to the best of your 
knowledge.  If  there  are  any  important  changes  you  will  notify  us  in  writing  immediately. You 
authorize  the  UICCU  to obtain  credit  reports  in  connection  with  this application  for  credit  and 
for  any  update,  increase,  renewal,  extension  or  collection  of  the  credit  received.  You 
understand that the UICCU will rely on the information in this application and your credit report 
to make its decision. If you request, the UICCU will tell you the name and address of any credit 

bureau  from  which  it  received  a  credit  report on  you.  It  is  a  federal  crime  to  willfully  and 
deliberately provide incomplete or incorrect information on loan applications made  to  federal 
credit unions or state chartered credit unions insured by the NCUA. 
2. You understand that the use of your card will constitute acknowledgement of receipt and
agreement to the terms of the credit card agreement and disclosures. MasterCard may not 
be used for any illegal transactions. 

SIGNATURE(S) 

 

 

Applicant Signature 

Date 

Other Applicant Signature 

Date 

Average Beacon  

Line-of-Credit amount approved $ 

Is this card replacing an existing UICCU Credit Card? Y/N 

FOR UICCU USE ONLY 

Originated by Employee Number: 

Approved by Employee Number:  

Rev 9/28/15 

Addendum to Card Holder Agreement  

UICCU Secured Credit Card Agreement and Disclosures 

In addition to the Card Holder Agreement for consumer credit transactions provided to you, by signing and/or submitting the 
Credit Union’s secured credit card application, you agree that: 

1.

If you are approved for this offer, you hereby accept this offer from University of Iowa Community Credit Union (the
“Credit Union”) for a secured consumer credit card account with the understanding that the amount deposited by you
(subject to any minimum required by Credit Union) in a new Secured Deposit Account will be used as security and
collateral to secure the obligations to the Credit Union stemming from your Secured Credit Card Account.

2. By signing this agreement, you request that the Credit Union open a Secured Deposit Account as described above,

subject to all Credit Union policies and applicable laws and regulations.  The owners of the Secured Deposit Account
are identical to the Cardholders on the Secured Card Account.

3. The Secured Deposit Account and Secured Credit Card Account that you are opening with the Credit Union is also

subject to the terms of the Card Holder Agreement, and by signing herein you agree to all terms in the Card Holder
Agreement. If there is a conflict between the Card Holder Agreement or any other agreement and this Agreement,
this Agreement will control.

4. The Credit Union will open the Secured Deposit Account in your name(s) subject to all Credit Union account policies.
You agree to provide a security deposit in the Secured Deposit Account that is at minimum equal to your credit
limit on your secured consumer credit card. THE SECURED DEPOSIT ACCOUNT DOES NOT EARN INTEREST.

5. The Secured Deposit Account is a security interest, pledge and assignment and is given as security for any amounts
you may owe under the Secured Credit Card. This means the Credit Union has control over the Secured Deposit
Account. You agree to surrender and irrevocably grant the Credit Union a security interest in the Secured Deposit
Account and any funds or balance held in said account. You may not make other withdrawals or electronic transfers to
or from the Secured Deposit Account unless all obligations are satisfied and the credit card has been closed. The
Credit Union may not send statements for the Secured Deposit Account. The Secured Deposit Account is not payable
at a specific date or after a specified period of time.

6. You agree that this security interest gives the Credit Union the right to redeem and withdraw from the Secured

7.

Deposit Account upon the default or termination, for all balances due including interest, fees, and principal, of the
Secured Credit Card offered herein. In order to facilitate recovery and upon the default of the Credit Card, the Credit
Union and its agent is authorized as attorney-in-fact to execute documents needed to recover the obligation owed.
If the Secured Credit Card is closed for any reason, Credit Union will apply funds in Secured Deposit Account to pay off
any obligations or balances due. If any funds remain in the account after all obligations (including interest and fees)
are satisfied, the remaining funds will be held by the Credit Union for 60 days before being returned to the owner(s)
of the Secured Deposit Account.

8. The Credit Union may require that you provide it with 7 days advance written notice of your request to close the

Secured Deposit Account, subject to the Credit Union’s rights under the Security Agreement. The Credit Union may
change these terms at any time by adding new terms or deleting or amending current terms.

9. Your signature(s) or other authentication will serve as verification for any transaction in connection with the Secured

Deposit Account.

10. You will receive a Card Holder Agreement with your card(s). The Card Holder Agreement becomes effective and you

agree to its terms by either using your Secured Card Account or by not closing your Secured Card Account within three
days of receipt of your Card Holder Agreement.

11. Secured Deposit Account:

_______________________________ 
  Date  
Cardholder Signature 

____________________________________ 
Date 
Cardholder Signature 

________________________________ 
Cardholder Name 

_________________________________ 
Cardholder Name 

Rev 9/28/15