Personal Credit Card Loan Application

Required Field

Loan Information

Amount Requested

Are you applying as an individual or jointly?

Individual
Joint
Guarantor
Co-Signer

Original Applicant Name

Please indicate by your initials if you intend to apply jointly.

Applicant Co-Applicant Please select which location you would like to submit your application to.

Applicant

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Mother's Maiden Name I.D. Type I.D. Number Date of Expiration Current Residency Start Date Physical Address City State Zip Code

Is your mailing address the same as your physical address?

Mailing Address City State Zip Code Primary Phone Number Work Phone Number E-mail Address Please do NOT email me important news and updates.

How would you prefer to be contacted?

Primary Phone
Work Phone
Email
Other

Housing Status

Own
Rent
Other

Estimated Property Value Mortgage Balance Monthly Mortgage or Rent Payment

Applicant Employment

Employed
Not Employed

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Have you worked here for more than three years? (No if unemployed)

Previous Employer (if less than three years at current)

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Note: Alimony, Child Support or Separate Maintenance Incomes do not have to be revealed unless you wish to have them considered in loan qualification.

Other Monthly Income Income Source

Financial Information

Do you have a checking account?

Checking Account Number Financial Institution

Do you have a savings account?

Savings Account Number Financial Institution

Co-Applicant

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Mother's Maiden Name I.D. Type I.D. Number Date of Expiration Current Residency Start Date Address City State Zip Code Primary Phone Number Work Phone Number E-mail Address Please do NOT email me important news and updates.

How would you prefer to be contacted?

Primary Phone
Work Phone
Email
Other

Housing Status

Own
Rent
Other

Estimated Property Value Mortgage Balance Monthly Mortgage or Rent Payment

Co-Applicant Employment

Employed
Not Employed

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Have you worked here for more than three years? (No if unemployed)

Previous Employer (if less than three years at current)

Employment Start Date Position or Title Gross Monthly Income Name of Employer Employer's Address City State Zip Code Employer's Phone Number

Note: Alimony, Child Support or Separate Maintenance Incomes do not have to be revealed unless you wish to have them considered in loan qualification.

Other Monthly Income Income Source

Financial Information

Do you have a checking account?

Checking Account Number Financial Institution

Do you have a savings account?

Savings Account Number Financial Institution

Credit Reference

List all debts, including second mortgage. Provide additional documentation if needed.

Lender

Name of Lender Address City State Zip Code Account Number Original Loan Amount Loan Balance Monthly Payment

 Add Another Lender Other Monthly obligations (i.e. child support)

Credit Information

Have you or your co-applicant ever declared bankruptcy?

Have you or your co-applicant ever had a judgment?

Have you or your co-applicant ever had a repossession or foreclosure?

Do you expect any disruptions or decreases in income?

If yes to any of the above, please explain.

Automatic Loan Payment

Do you want your monthly payment automatically deducted from your checking or savings account?

Automatically transferred funds will be applied as my monthly payment on each monthly due date so long as there are adequate funds on deposit or there is available credit in my account, until the loan is paid or the Bank receives written notice to cancel. I understand the Bank reserves the right to terminate the automatic repayment plan without notice.

Please initial your request

Interest Rates and Interest Charges
Purchases, Cash Advances & Balance Transfers	12.48% APR
How to Avoid Paying Interest on Purchases	Your due date is at least 25 days after the closing 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. The interest charges for cash advances begin on the transaction date.
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
Annual Fee	None

Penalty Fees
Late Payment	Up to $35

Transaction Fees
International Transaction	Up to 1% of the transaction amount in U.S. dollars
Cash Advance
Over The Counter	Either $1 or 2% of the amount of each cash advance, whichever is greater (maximum $20)
Obtained at an ATM	Either $1 or 2% of the amount of each cash advance, whichever is greater (maximum $20)

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

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING: This statement is submitted to obtain credit and I/ we certify that all information herein is true and complete. I / we agree that inquiries may be made to verify information and that credit references or verification may be given based on inquiries from other parties. This offer is subject to the credit policies of this institution. I / we agree to be bound by the terms and conditions of the bank card agreement, a copy of which will be mailed to the applicant if this application is granted, receipt of such agreement and acceptance of such terms to be conclusively presumed by the applicant's use. If this is a joint application, the undersigned shall be jointly and severally liable for any and all credit extended from time to time.

IMPORTANT INFORMATION ABOUT THE PROCEDURES FOR OPENING A NEW ACCCOUNT

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record all 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.

Applicant's Signature Date Co-Applicant's Signature Date

Transfer of Balance Request

Upon approval. I wish to transfer my present balance on the credit card account(s) listed below to my new credit card account.

Visa Account No. MasterCard Account No. Signature

Please send a copy of your last statement or drop off at your local branch.

Rev. 03/01/19 All terms and conditions are accurate as of this date; subject to change Member FDIC

Loan Information

Are you applying as an individual or jointly?

Please indicate by your initials if you intend to apply jointly.

Applicant

Is your mailing address the same as your physical address?

How would you prefer to be contacted?

Housing Status

Applicant Employment

Have you worked here for more than three years? (No if unemployed)

Previous Employer (if less than three years at current)

Financial Information

Do you have a checking account?

Do you have a savings account?

Co-Applicant

How would you prefer to be contacted?

Housing Status

Co-Applicant Employment

Have you worked here for more than three years? (No if unemployed)

Previous Employer (if less than three years at current)

Financial Information

Do you have a checking account?

Do you have a savings account?

Credit Reference

Lender

Credit Information

Have you or your co-applicant ever declared bankruptcy?

Have you or your co-applicant ever had a judgment?

Have you or your co-applicant ever had a repossession or foreclosure?

Do you expect any disruptions or decreases in income?

Automatic Loan Payment

Do you want your monthly payment automatically deducted from your checking or savings account?

Cash Advance

Transfer of Balance Request