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MasterCard Credit Card Application

MasterCard Credit Card Application

* Required Fields
I have read and agree to the MasterCard Credit Card Agreement:
I am applying for credit:

Applicant Information

Date of Birth:
 /   / 
Do You:
Check yes if you pay alimony, child support or separate maintenance payments?

Co-Applicant or Spouse

Complete this section only if Co-Applicant or Spouse is applying for a Joint Account.

Co-Applicant Date of Birth:
 /   / 
Does Co-Applicant:
Check if Co-Applicant pays alimony, child support or separate maintenance payments?

Proof of income must be provided. If self-employed or retired, attach financial statement and/or latest tax return.

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. I/We agree that all advances under this bank card account will be secured by the shares and deposit in all joint and individual accounts I/We have with the credit union now and in the future. I/We authorize the credit union to apply pledged amounts to repay this note in the event of default. The Ohio laws against discrimination requires that all creditors make credit equally available to all creditworthy 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. Application is accurate as of 11/2006.

Reminder regarding foreign transactions and currency conversion procedures: This notice serves as a reminder of MasterCard's policy regarding currency conversion for transactions in a foreign country. MasterCard's currency conversion procedure includes use of either a government mandated exchange rate, or a wholesale exchange rate selected by MasterCard, and the rate MasterCard uses for a particular transaction is a rate selected by MasterCard for the applicable currency on the day the transaction is processed, which may differ from the rate applicable on the date the transaction occurred or the date on which the transaction is posted to the cardholders account. Foreign transactions are subject to a fee by issuer, of up to 1% of the transaction amount for conversion and/or processing, and include any transaction where the merchant country is different than the country of the card issuer, regardless of whether currency conversion is performed. #013 07/06
I/We Agree:
Application Date:
 /   / 
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Security Code:



MasterCard Rate and Interest Charges

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