POPA Federal Credit Union VISA Application


PRIMARY APPLICANT

I am applying for:
Line of Credit Requested
$
VISA Classic
Individual Application
 Joint Application
Married
Unmarried Separated
Member Number
 Date of Birth
 Social Security No.
First Name
 Mi
 Last Name
Driver's License
 State
 Mother's Maiden Name
Present Street Address
(Do not use P.O. Box)
 City
 St
 Zip
Home Phone
 Work Phone & Ext.
 E-mail address
Present Employer
 Street Address
 City
 St
 Zip
Job Title
 Gross Monthly Salary Date of Hire
Source of other monthly income:
Property, Investments, Social Security, CD's, etc. 		Other Income
Relative Not Living With You
 Address
 City
 St
 Zip
Relationship Phone

DEBTS AND OBLIGATIONS

Primary Applicant
Renting Length of
Residence
 Monthly
Payment
Own Home
Other
List Other Monthly Payments: Alimony, Child Support, Others

Amount

CO-APPLICANT

Married Unmarried Separated
Member Number
 Date of Birth
 SSN
First Name
 MI
 Last Name
Driver's License
 State
 Mothers Maiden Name
Present Street Address
(Do not use P.O. Box)
 City
 St
 Zip
Home Phone
 Work Phone & Ext.
 E-mail address
Present Employer
 Street Address
 City
 St
 Zip
Job Title
 Gross Monthly Salary
 Date of Hire

DEBTS AND OBLIGATIONS

Co-Applicant
Renting Length of
Residence
 Monthly
Payment
Own Home
Other
List Other Monthly Payments: Alimony, Child Support, Others

Amount

CREDIT LIFE AND DISABILITY INSURANCE
Credit Life and Disability Insurance is optional and not required for me to obtain credit. See cost below.
YES, I am interested in applying for the Credit Life and/or disability Insurance. Please send me the additional required application.
No credit insurance. Please sign here to waive coverage X_______________________________________

SOLICITATION DISCLOSURE

Interest Rates and Interest Charges
Annual Percentage Rate (APR) for Purchases Visa Classic
12.00%
Visa Secured
12.00%
APR for Cash Advances Visa Classic
12.00%
Visa Secured
12.00%
How to Avoid Paying Interest on Purchases Your due date is at least 25 days after the close of each billing cycle. We do not charge you interest on purchases if you pay your entire balance by the due date each month.
For Credit Card Tips from teh Federal Reserve Board To learn more about factors to consider when applying for or using a credit card, visit the Web site of the Federal Reserve Board at http://www.federalreserve.gov/creditcard.
Fees
Transaction Fees
  • Foreign Transaction Fee

    • 1.00% of each multiple currency transaction in U.S. dollars
    0.80% of each single currency transaction in U.S. dollars
    Penalty Fees
  • Late Payment Fee
  • Over-the-Credit Limit Fee
  • Returned Payment Fee

    • $10.00
    $10.00 (if applicable)
    $10.00

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

    Effective Date.
    The information about the costs of the card described in this application is accurate as of July 1, 2010.

    OTHER DISCLOSURES
    Statement Copy Fee $3.00
    Document Copy Fee $25.00
    Rush Fee $50.00
    Emergency Card Replacement Fee $10.00
    PIN Replacement Fee None
    Card Replacement Fee $10.00
    Unreturned Card Fee None

    SIGNATURES: By transmitting this application to the Credit Union by mail, by fax, electronically, or by other means, you certify that the information you have provided is accurate and complete and that you have not omitted any material information. You authorize us to verify your statements, to check your credit, and to report our credit experience with you to others. You agree that your faxed signature on this application will have the same legal effect as your original signature. If we approve your credit request, you agree to the terms of the Credit Agreement, Truth in Lending Disclosure and any Security Agreement that we will provide to you upon approval. You agree that we have a lien on shares in any Credit Union account in which you have an interest, whether your loan is personal(signature) loan or is secured by other property such as a vehicle. Since you have requested a VISA Card, you agree that in consideration for and as a condition of our issuing a credit card to you, if you default, we can take funds in any Credit Union share account in which you have an interest to pay off, in full or in part, the amount you owe. This consent is not a pledge of any particular account or amount and will not affect your right to withdraw funds prior to our exercise of our rights.

    SIGNATURE X_______________________________________________DATE__________
    MEMBER NAME TO BE EMBOSSED ON VISA CARD: (19 CHARACTERS MAXIMUM)
    CO-APPLICANT'S SIGNATURE X___________________________________DATE__________
    CO-APPLICANT'S NAME TO BE EMBOSSED ON VISA CARD: (19 CHARACTERS MAXIMUM)
    I would like a card for each of the following additional authorized cardholders. I understand that there may be a $10.00 fee for each additional card.
    SIGNATURE OF AUTHORIZED CARDHOLDER X__________________________________DATE__________
    AUTHORIZED CARDHOLDER NAME TO BE EMBOSSED ON VISA CARD: (19 CHARACTERS MAXIMUM)
    AUTHORIZED CARDHOLDER'S SOCIAL SECURITY NUMBER: (12 CHARACTERS MAXIMUM)
    SIGNATURE OF AUTHORIZED CARDHOLDER X__________________________________DATE__________
    AUTHORIZED CARDHOLDER NAME TO BE EMBOSSED ON VISA CARD: (19 CHARACTERS MAXIMUM)
    AUTHORIZED CARDHOLDER'S SOCIAL SECURITY NUMBER: (12 CHARACTERS MAXIMUM)

    Please provide all of the requested information. When you have completed the form, press the "Submit Application" button to send your application to POPA Federal Credit Union for processing. The data will be transferred using our Secure Server. If you do not have an HTTPS compatible browser, you may simply print this form and fax it to (562) 404-4228 -. Or, mail it to us at:

    POPA Federal Credit Union
    13304 E. Alondra Blvd.
    Cerritos, CA 90703
    Attn: Financial Services Department

    Married applicants may apply for individual credit. Complete spousal information only if you are a resident of a community property state (CA, AZ, ID, NV, WI, LA, WA, NM, TX) or if you are relying on income or applying for joint credit with a spouse. Indicate marital status if applying for secured credit or residing in a community property state.

    Income from alimony/child or spousal support payments need not be revealed unless you wish the credit union to consider them as a basis for repayment of debt.

    If you are relying on income from alimony, child support or separate maintenance, complete the Co-Applicant section to the extent possible about the person on whose payments you are relying.