Visa Credit Card Application

Please provide all of the requested information. When you have completed the application, press the Submit button to send it to Mid American Credit Union.
This is an application for INDIVIDUAL CREDIT.

This is an application for JOINT CREDIT. Please enter the initials of both applicants to indicate agreement of a joint credit application: Applicant 1:   Applicant 2:

 


Personal Information

Name
Phone
Social Security No.
Birthdate
Today's Date
Address
City
State
Zip
Renting
Buying
Years
Employment Current employer
Phone
Years at this job

Member Account No.

Please make a selection below.
Single Credit Life Insurance
Yes No
Joint Credit Life Insurance
Yes No
Credit Disability Insurance
Yes No


Joint Applicant Information

Name
Social Security No.
Birthdate
City
State
Zip
Relationship
Phone
Employment Current employer
Phone
Years at this job


Income Information

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 loan


Borrower's gross monthly income
Borrower's Other income
Borrower's Source
Joint Applicant's gross monthly income
Joint Applicant's other monthly income
Joint Applicant's Source

Total of Monthly Income(s)


Mortgage Information or Monthly Rent

Home Mortgage Company Name
Appraised value
Original Debt
Balance
Payment
Landlord Name & Address
Rent



Yes No
I have had problems such as bankruptcy collections or repossessions.
If yes, please explain:

Yes No
I am currently a co-signer on a loan at MACU or another financial institution
If yes, for whom and balance of payments:

Yes No
I am obligated to pay child support or alimony.
If yes, the monthly amount is:

Agreement

By submitting this application, I am verifying and agreeing to the following information: The information above is true and complete. I request that you open the credit card account(s) checked above. I also request that the credit card(s) be issued in the name(s) shown above and that the credit card(s) be renewed and replaced until notice to the contrary is given. I authorize you to investigate my credit, and I authorize others to report their experience with me to you. I promise to pay in accordance with the current MACU VISA Agreement all charges made on the credit card account. I understand that these charges will be billed to my account. If I have indicated I wish to insure this account with credit insurance, I understand I will receive a separate application and disclosure containing specific information which I will need to sign and return in order to be insured.

Security Agreement and Pledge: By signing this application, I agree that all VISA advances under this card account are secured by all shares and deposits in all joint and individual accounts I have with MACU now and in the future. I authorize MACU to the extent permitted by applicable law, to apply the balance in these accounts to pay any amounts due on this account when I am in default without further notice. Shares and deposits in an Individual Retirement Account and any other account that would lose special tax treatment under state or federal law if given as security are not subject to the security interest I have given in my shares and deposits. Additionally, I understand that collateral purchased with this credit card account will secure this account and property securing other loans will also secure this account.

The USA Patriot Act has paved the way for financial institutions to help prevent fraud, identity theft, and the spread of terrorism. It requires financial institutions to obtain more informations from an individual or legal entity to help establish identity.



Disclosure Information

Information was accurate October 1, 1999 and is subject to change. Contact the Credit Union at : 8404 W. Kellogg Drive, Wichita, KS 67209 for up-to-date information.

ANNUAL PERCENTAGE RATE:

EVERYDAY VISA 14.9% ANNUAL PERCENTAGE RATE (Empirica Score 699 or below)

SELECT VISA 9.9% ANNUAL PERCENTAGE RATE (Empirica Score 700 or above)

PREFERRED YOUTH VISA 9.9% ANNUAL PERCENTAGE RATE

GRACE PERIOD FOR REPAYMENT OF PURCHASE BALANCES: You have 25 days from your statement closing day to repay your balance before a finance charge will be imposed. There is no grace period for cash advances.

METHOD OF COMPUTING THE BALANCE FOR PURCHASES: FINANCE CHARGE is calculated at the daily periodic rate on the daily balance of cash advances and average purchases on the account. The unpaid balance is determined each day during the statement period, beginning with the total of your Previous Balance, reduced by payments you make and credits we apply, and increased by purchases and cash advances you make and debit adjustments and fees we make during the statement period. Cash advances are always subject to FINANCE CHARGE from the posing date.

ADDITIONAL TRANSACTION FEES:
Cash advances: None
Over-the-limit fee: $10.00
Late payment fee: $15 is charged on payments more than 10 days late.
Draft retrieval fee: A fee of $15.00 is charged for a copy of a transaction on your account.
Returned payment: A fee of $10.00 is charged for each payment that is returned unpaid.
Reject telephone payment fee: $10.00
Replacement card: $5.00
Walk-thru card: $15.00 is charged for expedited card delivery.


ANNUAL FEE: NONE
MINIMUM FINANCE CHARGE: NONE
TRANSACTION FEE FOR PURCHASES: NONE

Illinois Residents: Residents may contact the Commissioner of Banks and Trusts for comparative information on finance charges, fees and grace periods. State of Illinois, CIP, P.O. Box 10181, Springfield, Illinois 62791, (800) 634-5452. Wisconsin Residents: Wisconsin law provides that no agreement, court order or individual statement applying to marital property will affect a creditor's interest unless prior to the time credit is granted, the creditor is furnished with a copy of the agreement, court order or statement, or has knowledge of the adverse provision. Ohio Residents: Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy customers and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio civil rights commission administers compliance with this law. California Residents: A married applicant may apply for a separate account. Maine Residents: This will notify you that a consumer report may be requested in connection with this application and you will be informed whether or not such report was requested. If a report is requested, you will be informed o f the name and address of the consumer reporting agency and furnished a copy of the report. New York Residents: A consumer report may be requested in connection with this application. Upon your request, you will be informed whether or not a consumer report was requested, and if it was requested, the name and address of the reporting agency that furnished the report.

 

Mid American Credit Union8404 West Kellogg DriveWichita, KS 67209316.722.3921Fax 316.722.0920