Fillable Printable Visa Credit Card Application
Fillable Printable Visa Credit Card Application
Visa Credit Card Application
Select one:
Limit requested:
VISA PLATINUM
Number of cards requested
_____ $
VISA GOLD
Number of cards requested
_____ $
VISA CLASSIC
Number of cards requested
_____ $
VISA SECURED
Number of cards requested
_____ $
APPLICANT (please print)
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.
MEMBER #
EMANTSALLAITINIELDDIMEMANTSRIF
HOME ADDRESS (STREET & NUMBER)
PIZETATSYTIC
SSERDDATASRAEYENOHPKROWENOHPEMOH
)()(
SOCIAL SECURITY #
DATE OF
BIRTH
EMPLOYER/TITLE
DATE OF HIRE
MONTHLY INCOME $
PREVIOUS EMPLOYER
HOW LONG?
OTHER INCOME AMOUNT $ SOURCE
EMPLOYER/TITLE
DATE OF HIRE
MONTHLY INCOME $
PREVIOUS EMPLOYER
HOW LONG?
OTHER INCOME AMOUNT $ SOURCE
CO-APPLICANT
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.
DEBTS
CHECK ONE: RENT OWN LIVE WITH PARENTS
SIGNATURES
MEMBER #
EMANTSALLAITINIELDDIMEMANTSRIF
HOME ADDRESS (STREET & NUMBER)
PIZETATSYTIC
SSERDDATASRAEYENOHPKROWENOHPEMOH
)()(
SOCIAL SECURITY #
DATE OF
BIRTH
RENT AMOUNT $
AUTO YEAR/MAKE/MODEL
AUTO LOAN BALANCE $
TOTAL OTHER DEBTS $
ADDITIONAL AUTHORIZED USER NAME(S): (must be 18 years of age or older)
1) 2)
PLEASE NOTE: YOU MUST INCLUDE TWO COPIES OF YOUR MOST RECENT PAYROLL STATEMENTS OR OTHER INCOME VERIFICATION
You warrant the truth of the above information and You realize that it will be relied upon by Us in deciding whether or not to grant the credit applied for. You hereby authorize Us, Our employees and agents
to investigate and verify any information provided to Us by You. If this application is for any Feature Category contained in Our Credit Line Account Program, You agree and understand that if approved, You are
contractually liable according to the applicable terms of the VISA Credit Card Agreement.
You will receive a copy of that Agreement no later than the time of Your first credit advance and You promise to
pay
all amounts charged to Your Account according to its terms. If this is a joint application, You agree that such liability is joint and several. You authorize Us to accept Your facsimile signatures on this appli-
cation and agree that Your facsimile signature will have the legal force and effect as Your original signature. You assume any risk that may be associated with permitting Us to accept Your facsimile signature.
If You are issued a credit card, by signing below, You grant and consent to a lien on Your shares with Us except IRA and Keogh Accounts) and any dividends due or to become due to You from Us to the
extent You owe on any unpaid credit card balance. I/We further understand that if I/We do not qualify for the VISA Gold card minimum credit limit, I/We may be offered a VISA Classic credit card instead.
I understand and acknowledge that when upgrading from a Gold card to a Platinum card, a portion of the total available Scorecard Points on my VISA Gold Card will be transferred to my new Platinum
Preferred card and qualify for a 1% Cash Back reward.
Select a 4-digit PIN that will allow your credit card to be used at an ATM. No Q or Z, select all letters or all numbers.
PAYMENT $
LENDER
TOTAL DEBT PAYMENTS $
HOME VALUE $ MORTGAGE PMT $ MORTGAGE BAL $
APPLICANT
ETADERUTANGIS
VISA Share Secured Applicants: If Your credit is approved, You grant Us a specific pledge of shares in Your Share Account indicated below and for the amount specified below:
Account Number _____________________________________________________ Amount $ ___________________________
SPOUSE/CO APPLICANT
ETADERUTANGIS
CREDIT UNION USE ONLY
GOLD
CREDIT LIMIT $
APPROVED
LOAN
OFFICER
DATE
DENIED
CLASSIC SECURED
PLATINUM
Limit requested:
Limit requested:
Limit requested:
VISA Credit Card Application
P.O. Box 7480
Philadelphia, PA 19101-7480
toll-free 800.806.9465
locally 215. 569.3700
fax 800.705.9069
mail@sb1fcu.org
www.sb1fcu.org
O:PDF: visa credit card application.pdf 7/5/11
Please check one: Joint
Individual
Optional Credit Union payment protection
A death can turn your credit card balance into a financial bur-
den for your family. Credit Life Insurance can lessen that burden
by paying the insurable balance on your credit card if you die.
Joint Credit Life is also available to insure the lives of you and a
second card holder, who is jointly and equally responsible for
payment of your credit card.
Only pennies a day
Your VISA statement will show the cost of each month’s insur-
ance payment and will be automatically added to your bill. All
you do is write one check. No separate bills or payments are
required. As long as you are under age 65, eligibility is guaran-
teed at time of VISA application.
Please check one:
I am interested in additional information
about credit insurance
I am not interested
Important Credit Card Disclosure
The following disclosure represents important details concerning Your
Credit Card. The information about costs of the Card are accurate as of the
effective date shown below. You can call or write Us at the telephone
number or address located on the back panel to inquire if any changes
occurred since the effective date.
ANNUAL
PERCENTAGE RATE
12.96% 14.88% 17.90%
Optional Bill Consolidation Authorization
Yes, I would like to consolidate my outstanding credit card balances as
a purchase (as opposed to a cash advance) and transfer to my credit union
VISA Credit Card.
Creditor #1
Payment address
Account # Amount to transfer $
Creditor #2
Payment address
Account # Amount to transfer $
Total $
Attach additional information if required
I have provided the information needed for credit card consolidation through
my credit union VISA Credit Card. I understand this plan is treated as a pur-
chase according to the terms set forth in my VISA disclosure. If my consolidat-
ed balance (above) exceeds my VISA limit, please pay off my accounts in the
order listed and notify me of which accounts cannot be paid in full.
Signature Date
Please print name
Member #
Automatic payment (option)
By signing below, you voluntarily elect to have your monthly
payment made by an automatic withdrawal from your share
draft checking account. The withdrawal will be made on the
date your payment is due.
Please check one:
Minimum payment Payment in full
____________________________________________________
Signature
HOW TO AVOID
PAYING INTEREST
ON PURCHASES
11.88%
VISA CARD GOLD CLASSIC SECURED
PLATINUM
VISA CARD GOLD CLASSIC SECURED
PLATINUM
LATE PAYMENT FEE
OVER THE LIMIT FEE
(after15 days past due)
NONE
$20
NONE
$20
NONE
$20
ANNUAL FEE
TRANSACTION FEES
FOR PURCHASE
NONE
$25NONE
$20
NONE
NONE
NONE
NONE NONE
NONE
NONE
NONE NONE
OVER THE CREDIT
LIMIT FEE
BALANCE TRANSFER FEE
NONE
NONE
NONE NONE
VISA CURRENCY
CONVERSION FEE
1%
OF TRANSACTION
1%
OF TRANSACTION
1%
OF TRANSACTION
1%
OF TRANSACTION
0.80%
OF TRANSACTION
0.80%
OF TRANSACTION
0.80%
OF TRANSACTION
0.80%
OF TRANSACTION
SINGLE CURRENCY
INTERNATIONAL
TRANSACTION FEE
NONE
O:PDF: visa credit card application.pdf 7/5/11
FEES
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
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.
EFFECTIVE DATE
April 2010
Average daily balance method
(including new purchases)
HOW WE WILL CALCULATE YOUR BALANCE
