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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