Please note that by selecting this link, you will be directed to Lea County State Bank’s Application site.  Certain portions of this site are maintained by a third party that has been selected and approved by Lea County State Bank.



Credit Card Application – Personal

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.

By selecting 'Submit Application' below, I agree to the terms and conditions listed in the disclosures.

LCSB Credit Card Disclosure

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General Information

Will you be applying for Individual or Joint Credit?

(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
Type of Card Requested *

Primary Applicant

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Home Address

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Time at Current Residence

Residence Type

Previous Address

Time at Previous Residence

Residence Type

Present Employer

*

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.

Previous Employer

CoApplicant

Home Address

Residence Type

Previous Address

Time at Previous Residence

Residence Type

Present Employer

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.

Previous Employer

References

Nearest Relative Not Living With You

Additional Information

How would you prefer to be contacted?

Income verification is required; other information may be required.

I certify that statements on this application are true and complete, by submitting this application, I authorize the Financial Institution to make any investigation of my credit, either directly or through any agency. (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.