| Print and complete the following form and send or fax to your Credit Union. | |||
| Torrance Office | Anna Office | East Liberty Office | Marysville Office |
| P.O. Box 2290 | 12500 Meranda Rd | 11000 S.R. 347 | 19775 S.R. 739 |
| Torrance CA 90509-2290 | Anna, OH 45302 | East Liberty, OH 43319 | Marysville, OH 43040 |
| Fax: (310) 781-6616 | Fax: (937) 498-5618 | Fax: (937) 644-6768 | Fax: (937) 642-5184 |
Account/Associate Number_____________________ Date________________________
1 Instructions
Whenever used in this application, the words Your and Your refer to the
applicants(s), and the words We, Us and Our refer to the Lender.
* Complete all the questions, or answer N/A. We are unable to
process incomplete applications.
* Sign the Application
* Sign the Insurance Authorization on the reverse side.
* Complete Spouse information only if the following apply
-This is for joint credit with Your Spouse.
-Your Spouse will use Your Account.
-You're relying on Your Spouse's income.
-You live in a community property state: AZ, CA, ID, LA, NM, NV,
-TX, WA, WI (and Puerto Rico)
* Attach a copy of Your latest paycheck stub or tax return.
2 Type of Credit Applied For:
If you live in a community property state, are you:
Married Separated Unmarried (Single, Divorced, Widowed)
Married Applicants may apply for individual credit. Would you like:
Individual Credit Joint credit with your spouse
Amount Requested $_______________ Number of Months ____
Purpose _____________________________________________
Collateral Offered ______________________________________
*Vehicle _________________________________________________
Make ____________________ Model _____________________ Year ____
VISA Classic - No. of Cards
___________________________
VISA Gold - No. of Cards _______________________________________
Yes, I want VISA Overdraft Protection for my Checking Account.
Yes, I want ATM Access on my VISA.
*Consolidation Loans _______________________________________
(Must List Bills to be Paid)
____________________________________________________________
____________________________________________________________
3 Applicant
Last Name ___________________________ First Name___________________ M.I._____
Address__________________________________________________________________________
City _______________________________ State ____________________ Zip __________
Drivers License Number_______________ Date of Birth ________________________
Social Security Number ______________ Home Telephone (___)________________
Name of Employer______________________________ Business Telephone (___)______________
Business Address___________________________________________________________________
Business City____________________________ Business State _________________________
Business Zip ____________________________ Hourly or Gross Monthly Pay ____________
Job Title/Shift__________________________ Date Employed _________________________
*Other Income (Source/Amount)_______________________________________________________
Number of Dependents______________ Mortgage Co/Landlord ________________________
Home: Rent Own Lease Other Mortgage or Rent $________________________________
Home Value $________________________ Total of all Monthly Payments $___________________
Child Support Payments $____________ 401K and Investment Balances_________________
Auto Lease Payments $_______________ Deposit Balances _______________________
Personal Reference
Name _________________________________________
Address _______________________________________
City___________________________________________ State_________________ Zip __________
Telephone (___)___________________
*NOTE: Alimony, child support, or separate maintenance income need not be
revealed if You do not choose to have it considered as a basis for this
credit request.
4 Co-Applicant
Last Name ___________________________ First Name___________________ M.I._____
Address__________________________________________________________________________
City _______________________________ State ____________________ Zip __________
Drivers License Number_______________ Date of Birth ________________________
Social Security Number ______________ Home Telephone (___)________________
Name of Employer______________________________ Business Telephone (___)______________
Business Address___________________________________________________________________
Business City____________________________ Business State _________________________
Business Zip ____________________________ Hourly or Gross Monthly Pay ____________
Job Title/Shift__________________________ Date Employed _________________________
*Other Income (Source/Amount)_______________________________________________________
Number of Dependents______________ Mortgage Co/Landlord ________________________
Home: Rent Own Lease Other Mortgage or Rent $________________________________
Home Value $________________________ Total of all Monthly Payments $___________________
Child Support Payments $____________ 401K and Investment Balances_________________
Auto Lease Payments $_______________ Deposit Balances _______________________
Personal Reference
Name _________________________________________
Address _______________________________________
City___________________________________________ State_________________ Zip __________
Telephone (___)___________________
*NOTE: Alimony, child support, or separate maintenance income need not be
revealed if You do not choose to have it considered as a basis for this
credit request.
5 Optional Credit Insurance
Credit Life and/or Credit Disability Insurance are not required to obtain credit
under this plan and, for Credit Line Accounts, will be included only if requested
immediately below by the APPLICANT. The insurance ratse for Credit Line Accounts
are shown below. For Credit Line Accounts, the insurance charge is calculated
each month by multiplying the outstanding balance of the Account on the last day
of that month by the rate shown. For Closed-End loans, the total insurance premium
will be calculated and disclosed to You separately.
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You must CHECK ONE OR MORE of the boxes below. CREDIT DISABILITY: Single Coverage - $2.59 Yes No VISA (Single Coverage) - $2.59 Yes No CREDIT LIFE: Single Coverage - $0.77 Yes No Joint Coverage - $1.26 Yes No Closed-End Loan Applicants - You must CHECK ONE OR MORE of the boxes below. You are interested in Credit Disability Insurance single coverage no |
|
ANNUAL PERCENTAGE RATE FOR PURCHASES |
VISA Classic - 11.50% - 18.00% (2 ) |
VISA Gold - 6.90% (1 )9.90% (1 ) | ||
|
Grace Period for Repayment of Balances for Purchases |
25 days on average |
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Method of Computing the Balance for Purchases |
Average Daily Balance (including new purchases) |
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Annual Fees |
None |
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Late Payment Fee |
20% of the interest due, minimum $.05 |
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|
Over the Credit Limit Fee |
$10.00 |
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(1) Introductory Rate. Your Account will be subject to an
Introductory Rate of 6.90%
for the 6-month period
immediately following the date that Your Account is established.
Any balance outstanding our Your Account on or after the expiration of
the Introductory
Rate period will be subject to an ANNUAL PERCENTAGE RATE of 11.50%
(2) Rates depend upon our underwriting criteria