Please PRINT this form, complete it and send to us by "Snail Mail". Sorry, we must have your signature(s) on file to open your account. However, you can also FAX your application to (406) 721-6125.

VISA® Credit Card Application

Fill out this VISA credit card application to apply for your VISA today! And while you’re applying for VISA, why not protect your credit card balance and your family with Credit Life and Disability Insurance. See details in the insurance sections to the right and return them to Montana Educators’ Credit Union.

Primary Applicant

Name will be embossed on the credit card as it appears below

Name: First Middle Initial or Name Last

Address

City State Zip

Home Phone                                 Work Phone
(     )                                             (      )

Social Security Number

Current Employer Monthly Gross Pay

$

Additional sources of income* Monthly Gross

$

Please issue an additional card on my account in the name of: Name: First      Middle Initial    or Name Last

 

Co-Applicant

Name will be embossed on the credit card as it appears below

Name: First Middle Initial or Name Last

Address

City State Zip

Home Phone                                  Work Phone
(     )                                             (     )

Social Security Number

Current Employer Monthly Gross Pay

$

Additional sources of income* Monthly Gross

$

*Alimony, child support, or separate maintenance income need not be revealed if the applicant does not desire to have it considered in determining creditworthiness.

Credit Information and Agreement

Montana Educators’ Credit Union may verify any of this information, and may check your credit and employment history from time to time. When your application is approved, your credit card and a Cardholder Agreement will be sent to you. You agree that if you use, or anyone applying with you uses the credit card or account, the Cardholder Agreement will be binding on you.
Pledge of Shares: If you have been issued a credit card, you understand and consent to a lien on your shares with us and any dividends due or to become due to you from us to the extent you owe on any unpaid credit card balances.
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. You agree and understand that if approved, you are contractually liable according to the terms of the Cardholder Agreement.
By using your credit card, you acknowledge receiving a copy of the Cardholder Agreement and 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.

Please read the "Credit Card Disclosure" below for rates, fees and other cost information before you sign and mail this application!

Primary Applicant’s Signature Date of Birth

X

Co-Applicant’s Signature Date of Birth

X

 

 

 

 

 

Credit Life and Disability Insurance

Credit Life and Disability Insurance protects your family from paying your debts at a time when they may be unable to afford it.
Credit Life Insurance can pay off your VISA balance if you die. If you have a joint account, your co-applicant can also apply.
(Applicants must be under age 66 to qualify.)
Credit Disability Insurance can help make your credit card payments if you become totally disabled. Credit Disability Insurance is available only to the primary cardholder. (Applicants must be under age 66 and working at least 30 hours a week.)
To apply for Credit Life and Disability Insurance, complete the following application for insurance. Choose single coverage to insure yourself or joint coverage (Life Insurance only) for you and a co-applicant. The cost, shown on the right, will be included on your monthly VISA statement during the months when you have an outstanding balance.

Creditor Beneficiary: Montana Educators’ Credit Union
Credit Life Insurance

Group Policy Number
28672-G-500

Insurance Maximum
$30,000.00

Max. Loan Repayment Period
120 Months

Credit Disability Insurance

Group Policy Number
28673-G-500

 Max. Mo. Benefit
$600.00 		Max. Loan Repayment period
120 Months

Waiting Period
30 days

RetroactiveBenefit
Yes 		Max. Aggregate Benefit
$30,000.00

Application for Group Credit Insurance

You are applying for the credit insurance coverage(s) selected below and agree to pay the required premium. You understand that fees may be paid by the insurer in connection with this coverage to the sponsor of this plan and/or its affiliates or designates. You understand that the purchase of this insurance is voluntary and not required in order to obtain credit, and that you may terminate it at any time. You also agree that: 1) you are eligible for Life Insurance if you are presently under age 66 and your loan is repayable within 120 months. The insurance maximum is $30,000. 2) If joint life insurance is selected, you are eligible if the older applicant is presently under age 66 and your loan is repayable within 120 months. You must be jointly and individually liable under the loan. Co-signers or guarantors are not eligible for insurance. 3) You are eligible for disability insurance if you are presently under age 66 and your loan is repayable within 120 months. The maximum monthly disability benefit is $600. You also must be presently working outside the home for wages or profit for 30 hours or more per week and have been so working for 30 days or more (or unemployed solely because of seasonal lay-off) immediately prior to this date. 4) A person signing this application as co-applicant is not eligible for disability insurance.

The following question must be answered to determine your eligibility for insurance:

During the last 2 years, have you been advised of or treated for: cancer, heart attack or coronary artery disease, stroke, cirrhosis, or Acquired Immune Deficiency Syndrome (AIDS) or AIDS Related Complex (ARC)?

APPLICANT __Yes __No C0-APPLICANT __Yes __No

Your answer to the above question is true to the best of your knowledge and belief. If you or your co-applicant answer "Yes" to this question, you understand that the person answering "Yes" is not eligible for insurance and will not be insured.

The effective date of your insurance will be the date of this application, the date the eligible loan is disbursed, or the date the note evidencing the loan is signed, whichever date is later.
Please check the coverage(s) requested.
__Single Credit Life 5.7¢*

__Joint Credit Life 9.1¢* 		__Credit Disability 21.5¢*

__ I do not wish either Life or Disabilit
coverage at this time

*Monthly premium per $100 of outstanding loan balance

Primary Applicant’s Signature Date of Birth

X

Co-Applicant’s Signature Date of Birth

X

 

 

 

 

Credit Card Disclosure

The following disclosure represents important details concerning your credit card. The information about the cost of the card is accurate as of the effective date shown below. You can call or write us at the address or telephone number listed on the front to inquire if any changes occurred since the effective date. Please note that this disclosure applies to cash advances as well as purchases.

Effective Date is May 1, 1998

Annual percentage rate for purchases

11.9%

Grace period for repayment of balances for purchases

You have 25 days to repay your balance before a finance charge will be imposed.

Method of computing the balance for purchases

Average daily balance including new purchases

Annual fees

None

Over-the-credit-limit fee

$10.00 for each billing cycle your daily balance exceeds your credit limit

Late-payment fee

5% of the total delinquent amount ($5.00 minimum)

Replacement card fee

$5.00

Transaction fee for cash advances obtained through an ATM is $2.00; through any other source is 1.00% of the amount of the advance, but in no event less than $2.00 or greater than $10.00