Diversified Credit Union
700 Linden Ave. W.  Minneapolis, MN 55403
Phone: 612-321-5301 or 1-800-333-7757
Fax: 612-321-5297

VISA APPLICATION

Important Notice about Procedures for Opening a New Account:
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 who opens an account.

APPLICANT INFORMATION

If you live in a community property state, are you:
  Married  Separated  Unmarried (Single/Divorced/Widowed)

Complete Co-Applicant information only if any of the following apply:
  1. This is for joint credit with Your Spouse or other Co-Applicant
  2. Your Spouse will use Your Account
  3. You're relying on Your Spouse's income as a source of repayment for the credit requested
  4. You live in a community property state (AZ, CA, ID, LA, NM, NV, TX, WA, WI or Puerto Rico)

Married applicants can apply for individual credit. Indicate if You would like:
Individual Credit     Joint Credit with Your Spouse   
Joint Credit with a Guarantor or another Applicant

APPLICANT

Name:   

CU Account #: (if applicable)        Social Security #: 

Birth Date: (need adult co-signer if younger than 21)

Address:  City: State:   Zip:

Home Phone:   Business Phone: Email Address:

DEBTS

Mortgage/Rent owed to:

Balance (Mortgage only):

$    Monthly Payment: $
INCOME

Employer:

Job Title:

    Gross Monthly Income:  $

Other Income:

Source:   $ Annual Monthly
(You need not list income from alimony, child support or separate maintenance payments unless you want it considered in evaluating this application.)
CO-APPLICANT

Name:   

CU Account #:      Social Security #:

Birth Date: (applicants under the age of 21 need an adult co-signer)

Address:   City: State:   Zip:

Home Phone:   Business Phone: Email Address:

DEBTS

Mortgage/Rent owed to:

Balance (Mortgage only):

$      Monthly Payment: $
INCOME

Employer:

Job Title

    Gross Monthly Income:  $  

Other Income:

Source:   $ Annual Monthly
(You need not list income from alimony, child support or separate maintenance payments unless you want it considered in evaluating this application.)

COMMENTS

Diversified Credit Union VISA Truth-in-Lending Disclosure

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 of October 13, 2009. You can call Us at (612) 321-5000 or write Us at 700 Linden Avenue West, Minneapolis, MN  55403 to inquire if any changes have occurred since the effective date.

 Interest Rate and Interest Charges

Annual Percentage Rates (APR)
for Purchases

 8.90%21.50% when You open Your account, based on Your creditworthiness.

     After that, Your APR will vary with the market-based Prime Rate.

Annual Percentage Rates (APR)
for Balance Transfers

 8.90%21.50% when You open Your account, based on Your creditworthiness.

     After that, Your APR will vary with the market-based Prime Rate.

Annual Percentage Rates (APR)
for Cash Advances

 8.90%21.50% when You open Your account, based on Your creditworthiness.

     After that, Your APR will vary with the market-based Prime Rate.

Paying Interest

We will not charge You interest on purchases if You pay Your entire balance owed each month within 25 days of Your statement closing date. We will begin charging interest on cash advances and balance transfers on the transaction date.

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 www.FederalReserve.gov/creditcard.

 Fees

Transaction Fees

  - Cash Advance
  - Foreign Transaction


$5.00
1.00% of each foreign currency transaction in U.S. dollars.
0.80% of each foreign U.S. Dollar transaction that occurs in a foreign country.

Penalty Fees

  - Returned Payment
  - Late Payment


Up to $25.00
Up to $25.00 after 14 days

How We Will Calculate Your Balance: We use a method called "average daily balance (including new purchases)."


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 Credit Line Account Agreement and Disclosure. 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 application and agree that Your facsimile signature will have the same 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.

Tab past this field:


 

      You hereby acknowledge Your intent to apply for joint credit __________________________
                                                                                                         Co-Applicant
 

X________________________________
Applicant Signature and Date (if printed form)

X________________________________
Co-Applicant Signature and Date (if printed form)

Both signatures required for joint application.

For Electronic Applications: Please press the Submit button on this page when ready.
For Printed Applications:
Press the Print button in your web browser's menu bar when ready. Sign the printed form and fax to 612-321-5297 or mail to Diversified Credit Union, 700 Linden Ave. W, Minneapolis, MN 55403.


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