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                                             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             
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.       Mon.  
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.       Mon.  

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  1-1-2016 home improvement   230695

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.

                                                                                                                        /           /
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 
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.  If your transaction is assigned to Connexus Credit Union 
(“Connexus”) you will be required to become a member.  Membership will be granted through joining the 
nonprofit Connexus Association (“Association”), a 501(c)(3) entity established to conduct charitable giving 
throughout the United States.  In that event, and by signing this application, you agree to join Connexus and 
the Association, and the terms of membership in each organization.

AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTS
By  signing  below,  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_____________________ Month First Payment is to be Drawn _______________

Bank Name ______________________________________________________________________

All terms are subject to change. 

Bank Address_____________________________________________________________________
If not filled in, you are authorized to deduct the payment amount set forth in my Revolving Credit Sales Slip for the account listed on my voided check.
IMPORTANT: PLEASE ATTACH A VOIDED CHECK WITH CORRECT ENCODING INFORMATION

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 

*Maximum Non-Introductory State  APR  Rates

12.00% Connecticut

14.40% Michigan

14.76% Pennsylvania 17.00% Arkansas

***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.

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.

Fees Vary By State

Up to $35 See Paragraph 11 of Agreement

Up to $35 See Paragraph 12 of Agreement

Penalty APR and 

When it Applies**

Paying Interest 

For Credit Card Tips from 

the Consumer Financial 

Protection Bureau 

Fees 

Penalty  Fees

•Late Payment 

•Returned Payment 

details.

Minimum Interest Charge If you are charged interest, the charge 

How  We  Will  Calculate  Your  Balance:  We  use  a  method  called  the  “Daily 

Balance  (including  new  purchases).”    See  your  account  Agreement  for  more 

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 

less than $1.00.

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.  

** The penalty APR rate does not apply in the following states: Arkansas, Colorado, Connecticut, 

Delaware,  Florida,  Illinois,  Kansas,  Louisiana,  Maine,  Maryland,  Massachusetts,  Michigan, 

Minnesota,  Missouri,  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, 

NM

MA

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 

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 

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 

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, Missouri, 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

GA

$5

$10

$15

$25

MN -$7.80 maximum                            5% of payment due

KY & WY ($10 minimum);

AL, ID & MI ($15 minimum);

HI, NE, VA

UT

OK ($5 minimum)

SC, TX, D.C.

AZ, CT, IL, LA, MD, ME, PA

5% of payment due;  $35 maximum*

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, OR, VA, WA

*($25 maximum-first occurrence in more than 6 months.) 

$10

$15

$20

$25

$30*

$35*

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.  

Minimum Monthly Payment Due shown on your billing statement will be the sum of the Minimum Monthly 

AR, CO, FL, IL, IN, KY, LA, MI, MN, NV, NH, NM, NC, OK, RI, TX, WI 

is the sum of the periodic INTEREST CHARGES for each purchase type rounded to the next highest 

18. SEVERABILITY:  If any provision of this Agreement is deemed void or unenforceable under any 

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. 

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. 

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.
AFI-550-RCA  1-1-2016 home improvement   230695

Bank Routing Number _____________________Depositor Account Number________________ 
Type of Account: 

 Checking 

 Savings

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

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

$                                           Yrs.       Mon.  

$                                                                                                $

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             

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.       Mon.  

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  1-1-2016 home improvement   230695

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 

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.  If your transaction is assigned to Connexus Credit Union 

(“Connexus”) you will be required to become a member.  Membership will be granted through joining the 

nonprofit Connexus Association (“Association”), a 501(c)(3) entity established to conduct charitable giving 

throughout the United States.  In that event, and by signing this application, you agree to join Connexus and 

the Association, and the terms of membership in each organization.

AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTS

By  signing  below,  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_____________________ Month First Payment is to be Drawn _______________

Bank Name ______________________________________________________________________

Bank Address_____________________________________________________________________

If not filled in, you are authorized to deduct the payment amount set forth in my Revolving Credit Sales Slip for the account listed on my voided check.

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.

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 

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.

Minimum Interest Charge If you are charged interest, the charge 

For Credit Card Tips from 
the Consumer Financial 
Protection Bureau 

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.

Fees Vary By State
Up to $35 See Paragraph 11 of Agreement
Up to $35 See Paragraph 12 of Agreement

Fees 
Penalty  Fees
•Late Payment 
•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

14.40% Michigan
12.00% Connecticut
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,  Missouri,  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  1-1-2016 home improvement   230695

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, Missouri, 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)
SC, TX, D.C.
AZ, CT, IL, LA, MD, ME, PA
NM
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. 

10% of payment due; $10 maximum

5% of payment due; $30 maximum*

5% of payment due; $15 maximum

5% of payment due; $20 maximum

5% of payment due; $10 maximum

5% of payment due; $5 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, RI, TX, WI 
AL, AK, GA, HI, KS, MT, SC, SD, TN
ND, OR, VA, WA
*($25 maximum-first occurrence in more than 6 months.) 

$10

$15

$20

$25

$30*

$35*

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 

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

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

$                                           Yrs.       Mon.  

$                                                                                                $

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             

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.       Mon.  

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  1-1-2016 home improvement   230695

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 

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.  If your transaction is assigned to Connexus Credit Union 

(“Connexus”) you will be required to become a member.  Membership will be granted through joining the 

nonprofit Connexus Association (“Association”), a 501(c)(3) entity established to conduct charitable giving 

throughout the United States.  In that event, and by signing this application, you agree to join Connexus and 

the Association, and the terms of membership in each organization.

AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTS

By  signing  below,  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_____________________ Month First Payment is to be Drawn _______________

Bank Address_____________________________________________________________________

If not filled in, you are authorized to deduct the payment amount set forth in my Revolving Credit Sales Slip for the account listed on my voided check.

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.

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 

*Maximum Non-Introductory State  APR  Rates

12.00% Connecticut

14.40% Michigan

14.76% Pennsylvania 17.00% Arkansas

***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.

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.

Fees Vary By State

Up to $35 See Paragraph 11 of Agreement

Up to $35 See Paragraph 12 of Agreement

Penalty APR and 

When it Applies**

Paying Interest 

For Credit Card Tips from 

the Consumer Financial 

Protection Bureau 

Fees 

Penalty  Fees

•Late Payment 

•Returned Payment 

details.

Minimum Interest Charge If you are charged interest, the charge 

How  We  Will  Calculate  Your  Balance:  We  use  a  method  called  the  “Daily 

Balance  (including  new  purchases).”    See  your  account  Agreement  for  more 

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 

less than $1.00.

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.  

** The penalty APR rate does not apply in the following states: Arkansas, Colorado, Connecticut, 

Delaware,  Florida,  Illinois,  Kansas,  Louisiana,  Maine,  Maryland,  Massachusetts,  Michigan, 

Minnesota,  Missouri,  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 

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. 

Bank Name ______________________________________________________________________

All 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, Missouri, 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)
SC, TX, D.C.
AZ, CT, IL, LA, MD, ME, PA
NM
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, RI, TX, WI 
AL, AK, GA, HI, KS, MT, SC, SD, TN
ND, OR, VA, WA
*($25 maximum-first occurrence in more than 6 months.) 

$10
$15
$20
$25
$30*
$35*

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. 

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 
creditworthy  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  1-1-2016 home improvement   230695

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 

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  1-1-2016 home improvement   230695

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.

the full amount due.

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.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
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.

applicable 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 

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 
creditworthy  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.

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.

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.

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  1-1-2016 home improvement   230695

AFI-550-RCA ORBIT  1-1-2016 home improvement   230695