CONNECTICUT FEDERAL CREDIT UNION
CONNECTICUT FEDERAL CREDIT UNION
97 WASHINGTON AVENUE ~ NORTH HAVEN, CT 06473
(203) 239-0346 ~ (203) 239-2346 ~ FAX - (203) 234-2867
VISA CREDIT CARD CREDIT LIMIT CHANGE REQUEST FORM
Requested Amount: $__________________
Name: ___________________________________________________________________________
Address: _________________________________________________________________________
City: ______________________________ State: _____________ Zip: ____________________
Home Phone: _______________ Work Phone: _________________ SSN: _______________
Employer Name: _________________________________________________________________ Employer Address: _______________________________________________________________
Salary: $____________ per Week ~ Month ~ Year (please circle one)
Other Income: $ ___________ per Week ~ Month ~ Year (please circle one)
Source of this income: _______________________________________
Monthly Payment:
Rent or Mortgage: $___________________
Car Loan/Payment: $___________________
Please list all other payments:
Made to: Monthly Amount:
______________________________ $ ___________________
______________________________ $ ___________________
______________________________ $ ___________________
______________________________ $ ___________________
This statement is submitted to obtain credit and I/we certify that all information herein is true and complete. I/we also authorize the CT Federal Credit Union to verify or obtain further information they may deem necessary concerning my/our credit standing. If this application is approved, the undersigned applicant’s by signing, using or permitting another to use the credit card, agree that the applicants will be bound by the terms and conditions accompanying the credit card and all amendments.
_______________________________________ _____________ ____________________________________ _____________ Signature Date Signature Date
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