Credit Card Application

• Application Type *
  Individual Individual with authorized user Joint
• Limit Requested *

Primary Applicant

• First Name *
• Last Name *
• Email
• Home or Cell Phone *
• Social Security Number *
• Date of Birth *
Drivers License Number *
Drivers License State *
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
• Address *
• Address Line 2
• City *
• State *
  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
• Zip *
• Mortgage Payment/Monthly Rent *
• Have you resided at your current address for fewer than 2 years? *
  Yes No
  Whether you have lived at your current address for more than 2 years is required

• If less than 2 years at current address:

  Previous Address

  Previous Address Line 2

  Previous City

  Previous State

  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

  Previous Zip

Employment Information

• Employment Type *
  Select One Employed Self Employed Retired Unemployed
• • Job Title
  • Employer Name *
  • Employer Address
  • Employer Address
  • Employer City
  • Employer State
    Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
  • Employer Zip
  • Employer Phone
  • Years at job
  • Gross Income per pay period *
  • Pay frequency *
    Weekly Bi-weekly Semi-monthly Monthly Annual
• • Estimated Self Employment Income *
  • Self Employment Pay frequency *
    Weekly Bi-weekly Semi-monthly Monthly Annual
• • Estimated Retirement Income *
  • Retirement Pay frequency *
    Weekly Bi-weekly Semi-monthly Monthly Annual

If employed for less than 2 years at your current job:

• Previous Employer Name
• Previous Employer Address
• Previous Employer City
• Previous Employer State
  Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
• Previous Employer Zip
• Previous Years and months at job

Agreement

• Do you have any outstanding judgments? *
  Yes No
  Whether you have outstanding judgments is required
• Have you ever filed for bankruptcy or had a debt adjustment plan confirmed under Chapter 13?*
  Yes No
  Chapter 13 Status is required
• Have you had property foreclosed upon or repossessed in the last 7 years?*
  Yes No
  Whether your property has been foreclosed is required
• Are you a U.S. Citizen or permanent resident alien? *
  Yes No
  Citizenship Status is required
• Is your income likely to decline in the next two years? *
  Yes No
  Whether your income is likely to decline is required
• If yes, what is the monthly payment *
• Are you liable for alimony, child support or maintenance programs? *
  Yes No
  Child Support Status is required
• If yes, what is the monthly payment *

Agreement

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 Freedom 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 authorize Freedom Credit Union to verify or re-verify any information contained in the application at any time. You understand that Freedom 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 federal crime to willfully and deliberately provide incomplete or incorrect information on the loan applications made to federal credit unions or state chartered credit unions insured by NCUA. You understand that the use of your card will constitute acknowledgement of receipt and agreement to the terms of the credit card agreement. A condition of your account is granting us a security interest in your share accounts. By signing below 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 any account that would lose special tax treatment under state or federal law if given as security are not subject to this security interest. When you are in default we may apply the balance in these accounts to any amounts due under the credit card agreement.

• Applicant Date
• Joint ApplicantAuthorized Applicant Date