APPLICATION AND SOLICITATION DISCLOSURE

VISA PLATINUM

Interest Rates and Interest Charges
Annual Percentage Rate (APR) for Purchases	11.25% to 18.00%, when you open your account, based on your creditworthiness. This APR will vary with the market based on the Prime Rate.
APR for Balance Transfers	11.25% to 18.00%, when you open your account, based on your creditworthiness. This APR will vary with the market based on the Prime Rate.
APR for Cash Advances	11.25% to 18.00%, when you open your account, based on your creditworthiness. This APR will vary with the market based on the Prime Rate.
Penalty APR and When it Applies	18.00% This APR may be applied to your account if you: - Make a late payment. How Long Will the Penalty APR Apply? If your APRs are increased for this reason, the Penalty APR will apply until you make six consecutive minimum payments when due.
How to Avoid Paying Interest on Purchases	Your due date is at least 25 days after the close of each billing cycle. We will not charge you any interest on purchases if you pay your entire balance by the due date each month.
For Credit Card Tips from the Consumer Financial Protection Bureau	To learn more about factors to consider when applying for or using a credit card, visit the website of the Consumer Financial Protection Bureau at http://www.consumerfinance.gov/learnmore.
Fees
Transaction Fees - Balance Transfer Fee - Cash Advance Fee - Foreign Transaction Fee	$15.00 or 1.00% of the amount of each balance transfer, whichever is greater $75.00 or 1.00% of the amount of each cash advance, whichever is greater 1.00% of each multiple currency transaction in U.S. dollars 0.80% of each single currency transaction in U.S. dollars
Penalty Fees - Late Payment Fee - Returned Payment Fee	Up to $25.00 Up to $25.00

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

Application of Penalty APR:
Your APR may be increased to the disclosed Penalty APR if you are 60 days late in making a payment.

Effective Date:
The information about the costs of the card described in this application is accurate as of: June 1, 2023.
This information may have changed after that date. To find out what may have changed, contact the Credit Union.

For California Borrowers, the Visa Platinum is a secured credit card. Credit extended under this credit card account is secured by various personal property and money including, but not limited to: (a) any goods you purchase with this account, (b) any shares you specifically pledge as collateral for this account on a separate Pledge of Shares, (c) all shares you have in any individual or joint account with the Credit Union excluding shares in an Individual Retirement Account or in any other account that would lose special tax treatment under state or federal law, and (d) collateral securing other loans you have with the Credit Union excluding dwellings.

Other Fees & Disclosures:
Late Payment Fee:
$25.00 or the amount of the required minimum payment, whichever is less, if you are one or more days late in making a payment.

Balance Transfer Fee (Finance Charge):
$15.00 or 1.00% of the amount of each balance transfer, whichever is greater.

Cash Advance Fee (Finance Charge):
$75.00 or 1.00% of the amount of each cash advance, whichever is greater.

Returned Payment Fee:
$25.00 or the amount of the required minimum payment, whichever is less.

Card Recovery Fee:
$75.00.

Card Replacement Fee:
$15.00.

Document Copy Fee:
$15.00.

Emergency Card Replacement Fee:
Up to $165.00.

PIN Replacement Fee:
$15.00.

Rush Fee:
$25.00.

Statement Copy Fee:
$15.00.

Credit Card Application

Instructions

Please provide all the requested information. When you have completed the form, press the Submit button to send your application. If necessary, we will contact you for additional information.

The items marked with (*) are required fields.

General Information

Will you be applying for Individual or Joint Credit? *

Joint
Individual

(If Joint, the co-applicant section has the same required fields as the primary applicant.)

Marital Status: Complete marital status if this loan is for: a. Joint or secured credit, or b. You reside in or rely on property located in a Community Property State. (AZ, CA, ID, LA, NM, NV, TX, WA, WI)

Marital Status

Unmarried
Married
Separated
This application is not for joint or secured credit and I do not live in the states listed above.

Type of Card Requested *

Number of Cards Requested *

Limit Requested $ *

Primary Applicant

Member Number

First Name *

Middle Name

Last Name *

Social Security Number (TIN) *

Date of Birth *

Number of Dependents

Ages of Dependents

Phone *

Email *

Drivers License # *

Drivers License State *

Mother's Maiden Name *

Home Address

Address 1 *

Address 2

City *

State *

ZIP Code *

Time at Current Residence

Years *

Months *

Residence Type *

Own
Rent
Other

Other

Monthly Payment *

Previous Address

Address 1

Address 2

City

State

ZIP Code

Time at Previous Residence

Years

Months

Residence Type

Own
Rent
Other

Other

Present Employer

Present Employer Name *

Present Employer Phone *

Employment Status *

Full Time
Part Time
Temp
Retired
Other

Job Title *

Job Start Date *

Gross Salary $ *

Per *

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 $

Per

Other Income Source

Previous Employer

Previous Employer Name

Previous Employer Phone

Employment Status

Full Time
Part Time
Temp
Retired
Other

Job Title

Job Start Date

Job End Date

Gross Salary $

Per

CoApplicant

Member Number

First Name *

Middle Name

Last Name *

Social Security Number (TIN) *

Date of Birth *

Number of Dependents

Ages of Dependents

Phone *

Email *

Drivers License # *

Drivers License State *

Mother's Maiden Name *

Home Address

Address 1 *

Address 2

City *

State *

ZIP Code *

Time at Current Residence

Years *

Months *

Residence Type *

Own
Rent
Other

Other

Monthly Payment *

Previous Address

Address 1

Address 2

City

State

ZIP Code

Time at Previous Residence

Years

Months

Residence Type

Own
Rent
Other

Other

Present Employer

Present Employer Name *

Present Employer Phone *

Employment Status

Full Time
Part Time
Temp
Retired
Other

Job Title *

Job Start Date *

Gross Salary *

Per *

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 $

Per

Other Income Source

Previous Employer

Previous Employer Name

Previous Employer Phone

Employment Status

Full Time
Part Time
Temp
Retired
Other

Job Title

Job Start Date

Job End Date

Gross Salary

Per

References

Nearest Relative Not Living With You

First Name *

Last Name *

Relationship *

Phone *

Address 1 *

Address 2

City *

State *

ZIP Code *

Second Reference

First Name *

Last Name *

Relationship *

Phone *

Address 1 *

Address 2

City *

State *

ZIP Code *

Debts Monthly Payments

List all other debts (for example, auto loans, credit cards, second mortgage, home assoc. dues, alimony, child support, child care, medical, utilities, auto insurance, IRS liabilities, etc.) Please use a separate line for each credit card and auto loan.

Debt 1

Debt 1 Monthly Payment $

Debt 2

Debt 2 Monthly Payment $

Debt 3

Debt 3 Monthly Payment $

Debt 4

Debt 4 Monthly Payment $

Debt 5

Debt 5 Monthly Payment $

Debt 6

Debt 6 Monthly Payment $

Debt 7

Debt 7 Monthly Payment $

Debt 8

Debt 8 Monthly Payment $

Debt 9

Debt 9 Monthly Payment $

Debt 10

Debt 10 Monthly Payment $

Additional Information

How would you prefer to be contacted?

Phone
Email Address
Other

Other

Special Instructions/Comments

Acknowledgement

Income verification is required; other information may be required.

I certify that statements on this application are true and complete. I authorize any person, association, firm or corporation to furnish, on request of this Financial Institution, information concerning me or my affairs.(Sec. 1014, Title 18, U.S. Code makes it a Federal Crime to knowingly make a false statement on this application.)

IMPORTANT: Please only select "Submit" once. It may take a few moments for the confirmation to appear.