APPLICATION

There are costs associated with the use of a credit card. Information about costs, rates and fees may be contained in disclosures provided with this
application or by calling us toll-free or collect at (800) 923-7328 or writing to us at the address stated on this application.
Check below to indicate the type of credit for which you are applying. Married Applicants may apply for a separate account.
Individual Credit: You must complete the Applicant section about yourself and the Co-Applicant/Spouse section about your spouse if
1. you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI)
2. your spouse will use the account, or
3. you are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support, or separate
maintenance, complete the Co-Applicant/Spouse section to the extent possible about the person on whose payments you are relying.
Joint Credit: Each Applicant must individually complete appropriate section below. If Co-Applicant is spouse of the Applicant, mark the Co-Applicant
and Spouse boxes.
Loan: Individual Joint Credit Card Account: Individual Joint
(Including Debit card access to the account if available)

Applicant Member Number Co-Applicant Member Number

If this is an application for joint credit, Applicant and Co-Applicant each agree and acknowledge the intent to apply for joint credit (sign below):
Applicant Date Co-Applicant Date

X (Seal) X (Seal)

Amount Requested Purpose/Collateral: Credit Limit Requested If Authorized User, Name:

$ $
Type of Loan: Term: BEYOND Visa New Increase Limit to: $
Signature
Personal Education Variable Rate Line of Credit
BOLD Visa Platinum New Increase Limit to: $
Vehicle Pension Share Certificate Secured Visa Secured New Increase Limit to: $

Payment Method: Cash or Check Automatic Transfer Credit Card Limit Increase

PAYMENT PROTECTION Are you interested in having your loan protected? YES NO

If you answer "yes", the credit union will disclose the cost to protect your loan. The protection is voluntary and does not affect your loan approval. In
order for your loan to be covered, you will need to sign a separate application that explains the terms and conditions.
APPLICANT CO-APPLICANT SPOUSE
NAME (Last - First - Initial) NAME (Last - First - Initial)

SOCIAL SECURITY NUMBER SOCIAL SECURITY NUMBER

BIRTH DATE EMAIL ADDRESS BIRTH DATE EMAIL ADDRESS

HOME PHONE CELL PHONE BUSINESS PHONE/EXT. HOME PHONE CELL PHONE BUSINESS PHONE/EXT.

PRESENT ADDRESS (Street – City – State – Zip) OWN RENT PRESENT ADDRESS (Street – City – State – Zip) OWN RENT

LENGTH AT RESIDENCE LENGTH AT RESIDENCE

MONTHLY MORTGAGE/RENT PAYMENT MORTGAGE BALANCE MONTHLY MORTGAGE/RENT PAYMENT MORTGAGE BALANCE
$ $ $ $
COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY COMPLETE FOR JOINT CREDIT, SECURED CREDIT OR IF YOU LIVE IN A COMMUNITY
PROPERTY STATE: PROPERTY STATE:
MARRIED SEPARATED UNMARRIED (Single - Divorced - Widowed) MARRIED SEPARATED UNMARRIED (Single - Divorced - Widowed)

© CUNA Mutual Group 2016 All Rights Reserved 00801814-AXX00-C-1-071620 (AXX002-E)

EMPLOYMENT/INCOME EMPLOYMENT/INCOME
EMPLOYMENT STATUS: EMPLOYMENT STATUS:
FULL TIME PART TIME SELF-EMPLOYED CONTRACTOR FULL TIME PART TIME SELF-EMPLOYED CONTRACTOR

NAME AND ADDRESS OF EMPLOYER NAME AND ADDRESS OF EMPLOYER

NOTICE: ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT NOTICE: ALIMONY, CHILD SUPPORT, OR SEPARATE MAINTENANCE INCOME NEED NOT
BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED. BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED.
EMPLOYMENT INCOME OTHER INCOME EMPLOYMENT INCOME OTHER INCOME
MONTHLY GROSS $ MONTHLY GROSS $ MONTHLY GROSS $ MONTHLY GROSS $
START DATE SOURCE START DATE SOURCE

MILITARY: IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR? YES NO MILITARY: IS DUTY STATION TRANSFER EXPECTED DURING NEXT YEAR? YES NO
WHERE ENDING/SEPARATION DATE WHERE ENDING/SEPARATION DATE

STATE LAW NOTICE(S)

Notice to Nebraska Residents: A credit agreement must be in writing to be enforceable under Nebraska law. To protect you and us from any
misunderstandings or disappointments, any contract, promise, undertaking, or offer to forebear repayment of money or to make any other financial
accommodation in connection with this loan of money or grant or extension of credit, or any amendment of, cancellation of, waiver of, or substitution for
any or all of the terms or provisions of any instrument or document executed in connection with this loan of money or grant or extension of credit, must
be in writing to be effective.
Notice to New York Residents: New York residents may contact the New York State Department of Financial Services to obtain a comparative listing
of credit card rates, fees, and grace periods. New York State Department of Financial Services: 1-800-342-3736 or [Link].
Notice to Ohio Residents: The Ohio laws against discrimination require 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.
Notice to Wisconsin Residents: (1) No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under
Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, or
has actual knowledge of its terms, before the credit is granted or the account is opened. (2) Please sign if you are not applying for this account or loan
with your spouse. The credit being applied for, if granted, will be incurred in the interest of the marriage or family of the undersigned.
Signature for Wisconsin Residents Only Date

X (Seal)

CONSENSUAL SECURITY INTEREST

You grant us a security interest in all individual and joint share and/or deposit accounts you have with us now and in the future to secure
your credit card account. Shares and deposits in an IRA or 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 you have given in your shares and deposits. You may withdraw these other shares
unless you are in default. When you are in default, you authorize us to apply the balance in these accounts to any amounts due without
notice, to the extent permitted by law. For example, if you have an unpaid credit card balance, you agree we may use funds in your
account(s) to pay any or all of the unpaid balance.

By signing or otherwise authenticating below, you are affirmatively agreeing that you are aware that granting a security interest is a condition
for the credit card and you intend to grant a security interest. You acknowledge and agree that your pledge does not apply during any
periods when you are a covered borrower under the Military Lending Act. For clarity, you will not be deemed a covered borrower, and your
pledge will apply, if: (i) you become obligated on a credit transaction or establish an account for credit when you are not a covered borrower;
or (ii) you cease to be a covered borrower.
Security Interest Acknowledgement and Agreement Date Security Interest Acknowledgement and Agreement Date

X (Seal) X (Seal)

SIGNATURES
By signing or otherwise authenticating below:
1. You promise that everything you have stated in this application is correct to the best of your knowledge. 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, and for other accounts, products, or services we may offer you or for
which you may qualify. You understand that the Credit Union will rely on the information in this application and your credit report to make its
decision. 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.
2. If you are applying for a credit card, you understand that the use of your card will constitute acknowledgment of receipt and agreement to the terms
of the Consumer Credit Card Agreement and Disclosure.
Applicant’s Signature Date Other Signature Date

X (Seal) X (Seal)

00801814-AXX00-C-1-071620 (AXX002-E)
CONSENT TO CONTACT
BY SIGNING BELOW, YOU AUTHORIZE BANK-FUND STAFF FEDERAL CREDIT UNION TO DELIVER OR CAUSE TO BE DELIVERED TO YOU
AT THE TELEPHONE NUMBERS PROVIDED ABOVE, ADVERTISING AND TELEMARKETING CALLS AND TEXT MESSAGE(S) USING AN
AUTOMATIC TELEPHONE DIALING SYSTEM AND/OR AN ARTIFICIAL OR PRERECORDED VOICE. YOU ARE NOT REQUIRED TO SIGN THIS
AUTHORIZATION OR ENTER INTO THIS AGREEMENT AS A CONDITION OF PURCHASING ANY PROPERTY, GOODS OR SERVICES. You may
withdraw the consent provided herein at any time by any reasonable means.

Applicant’s Signature Date Other Signature Date

X (Seal) X (Seal)

By executing this application, you agree we and/or our third-party debt collectors may contact you by telephone or text message at any telephone
number associated with your account, including wireless telephone numbers (i.e. cell phone numbers) which could result in charges to you, in order to
service your account or collect any amounts owed to us, excluding any contacts for advertising and telemarketing purposes as prescribed by law. You
further agree methods of contact may include use of pre-recorded or artificial voice messages, and/or use of an automatic dialing device. You may
withdraw the consent to be contacted on your wireless telephone number(s) at any time by any reasonable means. If you have provided a wireless
telephone number(s) on or in connection with this application, you represent and agree you are the wireless subscriber or customary user with respect
to the wireless telephone number(s) provided and have the authority to give this consent. Furthermore, you agree to notify us of any change to the
wireless telephone number(s) for which you are providing your consent to be contacted.

In order to help mitigate harm to you and your account, we may contact you on any telephone number associated with your account, including a
wireless telephone number (i.e. cell phone number), to deliver to you any messages related to suspected or actual fraudulent activity on your account,
data security breaches or identity theft following a data breach, money transfers, or any other exigent messages permitted by applicable law. These
contacts will not contain any telemarketing, cross-marketing, solicitation, advertising, or debt collection message of any kind. The contacts will be
concise and limited in frequency as required by law. You will have an opportunity to opt-out of such communications at the time of delivery.

00801814-AXX00-C-1-071620 (AXX002-E)