Amalgamated Bank Card Application

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

Getting Started

Thank you for choosing the Amalgamated Bank Card.

There is a minimum number of required fields marked with an (r), however the more complete this application is upon submission, the faster we will process it and the more likely it is that your application will be approved.

Please start by selecting the type of Amalgamated Bank Card that's right for you...

Standard MasterCard® (No Annual Fee)
Standard Plus MasterCard®(Annual Fee-See Bank Card Disclosures)

Gold MasterCard®(No Annual Fee)

Gold Plus MasterCard®(Annual Fee-See Bank Card Disclosures)
I prefer to receive a Gold MasterCard®. However, if I do not qualify I will accept a Standard MasterCard.

Yes! I am enrolling (if approved) in the optional AmalgaMiles Travel Program and agree to the $29 anual fee. See AmalgaMiles terms and conditions for details on the optional program.



Your Contact Information

First Name (r) The value is required.Invalid format.
Middle Initial
Last Name (r) The value is required.Invalid format.
Home Phone Number (r) The value is required.Invalid format.
Email Address (r) The value is required.Invalid format.
Present Street Address (r) The value is required.Invalid format.
City (r) The value is required.Invalid format.
State (r) The value is required. Invalid format.
Zip Code (r) The value is required.Invalid format.
How Long at Address*
Own
Rent
Other
Explain Other
*If you have lived at your current residence for less than two years, please indicate previous residence.
Previous Address
City
State
Zip Code Invalid format.
Name of Nearest Relative Not Living With You
Relationship
Relative's Phone Number Invalid format.
Relative's Address
City
State
Zip Invalid format.


Confirm Your Identity

Social Security Number (r) The value is required.
Mother's Maiden Name (r) The value is required.
Driver's License Number (r) The value is required.
Date of Birth (r) The value is required. Invalid format.
Number of Dependents


Employment and Income

Married WI Residents Only: If you are applying for an individual account or a joint account with someone other than your spouse, and your spouse also lives in Wisconsin, combine your financial information with your spouse's financial information.
Present Employer (r)* The value is required.
Self Employed?**
Position
How Long? (r) The value is required.
Monthly Pay (r) The value is required.
Business Address
City
State
Zip Code Invalid format.
Business Phone No. Invalid format.
If retired, when?
*If current employment is less than one year, please indicate prior employment or school attended.
Previous Employer or School Attended
How Long?
Monthly Pay
 

**If self-employed or retired, please include your CPA's name/address or send verification of annual income to:

Amalgamated Bank of Chicago
P.O. Box A3979
Chicago, IL 60690-9983


Basic Financial Information

Married WI Residents Only: If you are applying for an individual account or a joint account with someone other than your spouse, and your spouse also lives in Wisconsin, combine your financial information with your spouse's financial information.
Bank Name
Bank Address
City
State
Zip Code Invalid format.
Primary Account No.
Checking
Savings
Mortgagee or Landlord
Mortgagee/Landlord Address
City
State
Zip Code Invalid format.
Phone Number Invalid format.
Mortgage Account Number / Lease Number
Monthly Payment / Rent Invalid format.

*Note: You do not need to list alimony, child support, or separate maintenance payments UNLESS you want it to be considered as a basis for repaying this obligation.

Source of Other Income*
Other Income*


Co-Applicant Information

Disclosures and Send

MARRIED WI RESIDENTS ONLY: If you are a married resident of Wisconsin applying for an individual account or a joint account with someone other than your spouse, please provide the following information:
Applicant Spouse Co-Applicant Spouse

First Name

First Name
Middle Initial Middle Initial
Last Name Last Name
Street Address Street Address
City City
State State
Zip Code Invalid format. Zip Code Invalid format.

We want you to have your card as soon as possible!

Please click the View entire form for printing link below and verify that information you have provided is accurate and that any special fields that may apply to you are also completed.

View the entire form for review and printing

By typing my initials below as Applicant or Co-Applicant, I understand that I am electronically signing this application and certify that (i) I am at least 18 years of age, (ii) the information I have provided above is complete and accurate to the best of my knowledge, (iii) I have read and agree to the credit terms and other important information entitled "Application Disclosures" and "Privacy Principles" and (iv) I submit this application to obtain credit to be used for personal, family or household purposes only. If my application is approved, I agree to be bound by the terms of the Amalgamated Bank MasterCard Cardmember Agreement ("Cardmember Agreement"), which will be provided to me with my credit card(s) upon approval. In addition, I authorize the Bank to make inquiries (including requesting reports from consumer credit reporting agencies and other sources) in evaluating my application and subsequently in connection with any extension of credit, update, renewal, review or collection of my account or any other lawful purpose. Upon my request, the Bank will tell me whether or not a consumer report was requested and the name and address of any consumer reporting agency that furnished the report.

 

Applicant initial here: and check here to indicate that you agree to receive the Privacy Principles electronically and acknowledge that you received the Privacy Principles electronically.
Co-Applicant initial here: and check here to indicate that you agree to receive the Privacy Principles electronically and acknowledge that you received the Privacy Principles electronically.

Before clicking "Send" to submit your application electronically, please make sure you have read and accepted the terms of this Application, including the Application Disclosures and Privacy Principles.


If you prefer to submit this application form by U.S. mail, please sign (all applicants) and date below and mail to:

Amalgamated Bank
P.O. Box 83979
Chicago, IL 60690

Signature of Applicant Date

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Signature of Co-Applicant Date

__________________________________

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