Applications are intended for Utah state residents only.

Account Ownership
Individual
Joint

Card Type
Visa Gold Credit Card
Requested Credit Limit:
*$50,000.00 gross annual income required for credit limits over $5,000.00. Credit limit requests over $10,000.00 require financial statement and tax return.
Applicant Information
Name (First M. Last):
SSN:
Date of Birth (mm/dd/yyyy):
Number of Dependents:
Mother's maiden name:
Home Phone Number: ( ) -
Cell Phone Number: ( ) -
Email:
Address:
City, State: ,
Zip-Plus4: -
Residential Status: Own   Rent   Other
Length at Current Address: years
Monthly Payment: $
Employer:
Job Title:
Length of employment: years
Employer's Address:
City, State: ,
Zip-Plus4: -
Work Phone Number: ( ) -
Gross Monthly Income: $
Nearest Relative
not living with you
Name (First Last):
Address:
City, State: ,
Zip:
Relationship :
Phone Number:
Co-Applicant Information
Name (First M. Last):
SSN:
Date of Birth (mm/dd/yyyy):
Number of Dependents:
Mother's maiden name:
Home Phone Number: ( ) -
Cell Phone Number: ( ) -
Email:
Address:
City, State: ,
Zip-Plus4: -
Residential Status: Own   Rent   Other
Length at Current Address: years
Monthly Payment: $
Employer:
Job Title:
Length of employment: years
Employer's Address:
City, State: ,
Zip-Plus4: -
Work Phone Number: ( ) -
Gross Monthly Income: $
Nearest Relative
not living with you
Name (First Last):
Address:
City, State: ,
Zip:
Relationship :
Phone Number:
Other Information
  Applicant Co-Applicant
  Deposit Accounts
  Acct. No. Acct. Balance Acct. No. Acct. Balance
Checking
Bank Savings
Savings & Loan
Credit Union
  Credit History
  Balance Due Monthy Payment Balance Due Monthy Payment
Mortgage/Rent
Other Mortgage
Credit Card
Credit Card
Dept. Store
Auto Loan
Auto Loan
  General Information
Are you a permanent U.S. resident? Yes No Yes No
Have you ever declared bankruptcy? Yes No Yes No
Are you a co-maker or endorser on any loan? Yes No Yes No
Are there any unsatisfied judgements against you? Yes No Yes No
VISA GOLD CREDIT CARD DISCLOSURE OF TERMS:


Annual Percentage Rate (APR) for Purchases, Cash Advances and Balance Transfers10.95% Fixed
Other APR'sPenalty Rate: 21% See explanation*
Balance Calculation Method for Purchases & Cash AdvancesAverage Daily Balance (including new purchases) (1)
Grace Period for Repayment of Balances for Purchases & Cash Advances25 Days (2)
Annual FeeNo Annual Fee
Minimum Finance Charge for Purchases & Cash Advances$0.50 (Unless Purchase Average Daily Balance is Zero)
Transaction Fee for Cash Advances2.5% of amount advanced with a $5.00 minimum charge per Cash Advance. (3)
Currency Conversion Fee1% of the "Foreign Country Transaction" (4)
Balance Transfer FeeNone
Late Payment FeeUp to $30.00 (5)
Returned Payment Fee$25.00
Business CB Rewards Annual Fee (For Business Accounts Only)$50.00 (6)
Website
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 http://www.consumerfinance.gov/learnmore.


*Explanation of Penalty Rate: If a VISA Account reaches 60 days Past Due: 1) The APR will increase to 21% for Purchases, Cash Advances, and Balance Transfers, 2) Your account will be closed and no longer be available for use, 3) You will still be responsible for any outstanding balance on your account by making the required minimum payment, 4) Any CB Rewards points you have earned will be forfeited when your account is closed. The Account will remain at the Higher Rate until Regular Monthly Payments have been received on the account for a Six Month Period after the Increased Rate went into effect. The Rate at that time will automatically change back to the Regular Rate assigned to the Account originally, which is disclosed above under Annual Percentage Rate. Notification of Penalty APR will be sent 45 days before increase. Terms of Penalty Rate can be waived at the Bank's discretion at any time.

(1)     METHOD OF COMPUTING THE BALANCE FOR PURCHASES & CASH ADVANCES:
The Average Daily Balance is computed by adding together the Daily Outstanding Balances and New Purchases (Advances and Advance Transaction Fees for the current billing period, Annual Fees, Late Fees, Returned Payment Fees, Currency Conversion Fees, and Finance Charges, if any, will not be included in the "Average Daily Balance" calculation) on each day of the Billing Cycle and dividing the resulting sum by the number of days in the billing cycle. The Finance Charge is calculated by adding any Transaction Charges imposed on New Cash Advances to the amount determined by applying a Monthly Periodic Rate to the above described Average Balance.

(2)     GRACE PERIOD FOR REPAYMENT OF BALANCE FOR PURCHASES & CASH ADVANCES:
On purchases and cash advances, the cardholder will have a Grace Period of at least 25 days, calculated from the Statement Closing Date to the Payment Due Date. If the New Balance is not paid in full by the Payment Due Date, you will be assessed a Finance Charge on the THEN Outstanding Balance and on all New Purchases and cash advances from the date such Purchases and cash advances are posted to your Account.

(3)     TRANSACTION FEE FOR CASH ADVANCES:
Transaction Charge for Cash Advances is 2.5% of the Amount Advanced with a Minimum Charge of $5.00 per Advance. The Transaction Charge for Cash Advances will appear on your Monthly Statement as a "Cash Advance Fee: and the Fee will appear on your statement the same date the Cash Advance appears. A Cash Advance Fee will increase the "Annual Percentage Rate" for the month in which the Cash Advance occurs.

(4)     CURRENCY CONVERSION FEE DISCLOSURE:   To the extent that I have used my VISA card to purchase goods or services, or to obtain cash in another country outside the U.S., my statement may reflect the conversion into U.S. Dollars of all such "Foreign Country Transactions." The exchange rate applied to such transactions is a: 1) Wholesale Market Rate, or 2) Government-Mandated Rate, which is in effect one day prior to the processing date. The VISA account will be assessed a fee of 1% of the "Foreign Contry Transaction" and this fee will appear on the billing statement as an "International Transaction (TXN) Fee."

(5)     LATE CHARGE:  A Late Fee may assess if your Minimum Payment is not made by the tenth day following your Due Date. This Fee may be up to $30.00 for each Late Period.

(6)     BUSINESS CB REWARDS ANNUAL FEE:   This $50.00 Fee will be assessed annually for Visa Gold Cards for each account issued under a Business Name. This Fee will be waived if the business elects to not participate in the CB Rewards Program

OTHER FEES:   Copy of transaction $20.00 per copy; copy of statement $5.00 per copy; research fee $25.00 per hour; photo cards or additional plastics $2.50 per card, fee for opening new account as result of a lost/stolen account $5.00; fee to reopen a Visa account previously closed $10.00; year end statement fee $5.00.

NOTICE CREDIT HISTORY FOR MARRIED PERSONS:
The Federal Equal Credit Opportunity Act and the Utah Uniform Consumer Credit Code forbids all creditors from discriminating against any applicant on the basis of sex or marital status in any respect of a credit transportation. Regulations adopted under the Act give married persons the right to have credit information concerning those credit accounts that they hold or use jointly with a spouse reported to consumer reporting agencies and creditors in the name of both wife and husband. Accounts of married persons opened before November 1976-even those opened in the names of both spouses- are often reported in only the husband's name. This is generally true regardless of who has been paying the bills or whose income was used to obtain the account. As a result, many married women do not have a credit history in their own names although their husbands do. If a woman ever needs to obtain credit on her own, for example, when divorced or widowed, a credit history is usually necessary. If your account(s) with us is a joint account which you share with your spouse or an account(s) in the name of one spouse which the other spouse is authorized to use, you have the right to have credit information concerning it reported in both your name and your spouse's name. If you choose to have credit information concerning your account(s) with us reported in both your name and the name of your spouse, please fill in the statement below and return it to us. Please note that the Federal regulation provides that your signature below will not make either you or your spouse legally liable for any different or greater debts. It will only request that credit information be reported in both your names. When you furnish credit information on this account, please report all information concerning it in both your names as follows.

SIGNATURES:
I/WE CERTIFY THAT the above is true and complete. I/WE HAVE READ and agree to all the terms and conditions set forth in the Application & Cardholder Agreement. The undersigned shall be liable for charges made on this account. I/WE AUTHORIZE YOU TO GATHER WHATEVER CREDIT INFORMATION YOU CONSIDER NECESSARY AND APPROPRIATE.