Business Credit Card Application

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Important Information About Procedures for Applying for a Loan

To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person or business that opens an account.

What this means for you: When you open an account, we will ask for your name, address, date of birth, if applicable, and other information that will allow us to identify you.

We may also ask to see your driver's license or other identifying documents.

Married Applicants may apply for a separate account.

Member/Account Number:*

Type of Credit:*

Individual/Business

Joint (Co-Applicant must individually complete Co-Applicant Information)

Amount Requested:*

Purpose of Loan:*

Applicant/Individual Information

Business/Individual Name*

Year Business Established*

State*

State

DBA Name(s)

Prior Business Name(s)

Contact Name*

First Last

Title

Telephone*

Type of Organization:*

Individual

Sole Proprietorship

Partnership

Corporation

LLC

Association

Non-Profit

Other

Employer Name:

Employer Telephone Number

SSN/TIN Number

Driver's License Number

DL State

State

DL Issuance Date

Month

Day

Year

DL Expiration Date

Month

Day

Year

Date of Birth*

Month

Day

Year

Home Telephone

Work Telephone

Cell Phone

Fax Number

Website Address

Email Address*

Physical Address*

Street Address City State ZIP Code

Complete for Joint Credit, Secured Credit, or if you live in a community property state:*

Married

Separated

Unmarried (Single - Divorced - Widowed)

ID Verification:

Guarantor/Co-Applicant

Do you have a Guarantor or Co-Applicant?*

Yes

Guarantor/Co-Applicant Information

I am providing the following information for purposes of serving as a:	SSN/TIN Number	Date of Birth	Name	Driver's License Number	State	DL Issuance Date	DL Expiration Date	Home Telephone	Work Telephone	Cell Phone	Fax Number	Website Address	Email Address	Physical Address	Complete for Joint Credit, Secured Credit, or if you live in a community property state:	ID Verification	Actions

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Sources of Income

Important Notice to Individuals

Alimony-Child Support: The inclusion of alimony, separate maintenance, or child support as income is voluntary and need not be revealed if you do not wish to have it considered in evaluating this application.

Applicant Income

Net Sales

Base Salary

Overtime

Bonus and/or Commission

Dividends/Interest

Net Rental Income

Itemized Other Income

Other Source of Income	Amount	Actions

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Applicant Gross Annual Income Total

Guarantor or Co-Applicant #1 Income

Net Sales

Base Salary

Overtime

Bonus and/or Commissions

Dividends/Interest

Net Rental Income

Itemized Other Income

Other Source of Income	Amount	Actions

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Guarantor or Co-Applicant #1 Income Total

Guarantor or Co-Applicant #2 Income

Net Sales

Base Salary

Overtime

Bonus and/or Commissions

Dividends/Interest

Net Rental Income

Itemized Other Source of Income

Other Source of Income	Amount	Actions

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Guarantor or Co-Applicant #2 Income Total

Spouse Income (If Applicable)

Net Sales

Base Salary

Overtime

Bonus and/or Commissions

Dividends/Interest

Net Rental Income

Itemized Other Source of Income

Other Source of Income	Amount	Actions

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Spouse Income Total

Sources of Income Totals

Total Annual Income for all Sources

Financial Information

Please include copies of the following checked items as attachments to this application:

Financial Documents

Federal Tax Return For:

Current Year

Borrower

Guarantor/Co-Applicant(s)

Other

Other Federal Tax Return

Borrower

Guarantor/Co-Applicant(s)

Balance Sheet for Current Year for:

Borrower

Guarantor/Co-Applicant(s)

Income Statement for Current Year for:

Borrower

Guarantor/Co-Applicant(s)

Financial Services Accounts Information

Loan(s)

Borrower

Guarantor/Co-Applicant(s)

Other Accounts

Type of Other Accounts

Borrower

Guarantor/Co-Applicant(s)

Additional Account Information

Check if additional account information accompanies this application.

Upload Your Documents

Drop files here or

Max. file size: 400 MB.

Signatures

You promise that everything you have stated in this application is correct to the best of your knowledge and that the above information is a complete listing of what you owe. If there are any important changes you will notify us in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application for credit and for any update, increase, renewal, extension or collection of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. You agree that requested documentation that accompanies this application is complete and correct and that it's incorporated as part of this application. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a crime to willfully and deliberately provide incomplete or incorrect information in this application. The person(s) signing the application is/are indeed authorized to act on behalf of the borrower. Borrower, co-applicant(s), and guarantor(s), as appropriate grants to the credit union the authority to use reasonable means to verify application information by requesting credit bureau reports, accessing information about borrower, co applicant(s), and guarantor(s), as appropriate from other third party information providers, and other means if applicable.

Borrower further grants to credit union the right to share this information with third parties as reasonable in the normal course of doing commercial lending including sharing this information with a third party for purposes of underwriting the loan. Borrower agrees to pay any fees charged by the credit union for processing this application and other related expenses whether the application is approved or denied. You promise that the credit you are applying for is for a business purpose. By signing below or by using your card, you understand that either of those actions will constitute acknowledgment of receipt and agreement to the terms of the credit card agreement and disclosures.

Add Signatures

Signature	By:	Date	Actions

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Name

This field is for validation purposes and should be left unchanged.