VISA CREDIT CARD APPLICATION Build or Rebuild Your Credit.
嚜澹OR SECURITY PURPOSES, COMPLETED APPLICATIONS MAY NOT BE RETURNED VIA EMAIL
DO NOT FAX
SECURED VISA? CREDIT CARD APPLICATION
Build or Rebuild Your Credit.
1
Visa? Max Cash Secured Card
Secured Visa? Card
5% Cash Back
Lower APR
5% cash back 2 on two categories you choose 每
first $2,000 in combined purchases each quarter3
29.24%* APR on purchases and
balance transfers.
2% unlimited cash back on one everyday
category of your choice
Non-Rewards
1% unlimited cash back on all other eligible
purchases4
No annual fee*
29.99%* APR on purchases and balance
transfers.
No annual fee*
APPLY TODAY
Upon approval, your deposit will be used to
open a secured savings account that is pledged
as security for your credit card account.
Your credit line is your deposit amount. If your
account is closed and the balance paid in full,
the deposit, plus interest, is returned to you.
L ate payments or going over the credit limit may damage your credit history.
Cash rewards can be redeemed as a deposit to a checking or savings account with this Financial Institution only, which will be deposited within seven business
days, or as a statement credit to your credit card account, which will be deposited within one to two billing cycles or as a Rewards Card ($25 minimum
redemption).
3
Max Cash Secured Card: Cardmember must initially enroll into categories of their choice, or all net purchases will earn no more than 1% cash back. Categories
are subject to change. You will earn 5% cash back on your first $2,000 in combined net purchases each calendar quarter in your two chosen 5% categories
and unlimited cash back in your 2% category. All other net purchases earn 1% cash back. Transactions qualify for 5% or 2% cash back based on how
merchants classify the transaction. Upon approval, full details will be provided in your Cardmember Agreement. Cash rewards do not expire as long as the
account remains active. If there is no reward, purchase, or balance activity on your account for 12 statement cycles, your cash rewards balance will expire.
4
The Elan Rewards Program is subject to change. Rewards earned on eligible net purchases (purchases minus credits and returns). Not all transactions are
considered to be Purchases and eligible to earn rewards, such as transactions posting as Convenience Checks; Balance Transfers; Advances (including ATM
withdrawals, wire transfers, traveler*s checks, money orders, foreign cash transactions, betting transactions, and lottery tickets); interest charges and fees;
credit insurance premiums; and transactions to (i) fund certain prepaid card products, (ii) buy currency from the U.S. Mint, or (iii) buy cash convertible items.
*Balance Transfer fees of 3% of each transfer amount ($5 minimum) apply. See the Summary of Visa Account Terms on Page
5 for the full terms of the offer, including the Right to Change Terms.
1
2
SEC STD 08/24
Page 1 of 5
DO NOT FAX
FOR SECURITY PURPOSES, COMPLETED APPLICATIONS MAY NOT BE RETURNED VIA EMAIL
SECURED VISA? CREDIT CARD APPLICATION
APPLICANT*S INFORMATION & CITIZENSHIP
IT* EASY TO APPLY!
CARD OPTIONS
CHOOSE ONE
Elan Location Code (Required)
If no Location Code indicated,
App can not be processed.
All fields are REQUIRED. Any missing information may cause your application to be delayed or declined.
Rewards 每 Visa Max Cash Secured USV SC 43225 PC 0719 KP:G
Non Rewards 每 Secured Visa USV SC 37927 PC 7377 KP:G
Note: If no selection is made or multiple products are selected, we will process your application for a Max Cash Secured Card.
SEE SUMMARY OF VISA ACCOUNT TERMS ON PAGE 5 FOR RATES, FEES AND OTHER COST INFORMATION.
Please complete this application in dark blue or black ink.
1. Complete and sign this application.
2. Include a check payable to Elan Financial Services to establish your secured savings account ($300 minimum, $5,000 maximum).
The deposit must be a cashier*s check or money order. Personal checks or third party checks are not
accepted. DO NOT SEND CASH. Check must be made out in even hundred dollar increments.
3. Mail the completed application and check to: Secured Card Processing, PO Box 6363, Fargo, ND 58125-6363
First Name
Middle Name
Last Name
Suffix
Date of Birth
Social Security Number
or ITIN (Individual Tax ID Number)
???/???/
????每???每
???每???每
Street Address (No PO Boxes Allowed, U.S. Addresses Only)
Suite/Unit #
City
State
Primary Phone #
Mobile Phone # (Optional)
(????)????每?????
(????)????每?????
ZIP Code
Email Address1
Mailing Address (If Different Than Above, U.S. Addresses Only)
Suite/Unit #
City
State
ZIP Code
Country of Citizenship
1
e use email to communicate information about your credit card application and booked credit card accounts. Confidential, personal or financial information will never
W
be sent or requested using the email provided.
Employment Status (Check one)
Full-time Employment
Part-time Employment
Work Phone #
Unemployed
Self-Employed
Homemaker
Retired
Student
Military
Occupation (Enter name of your current or most recent occupation or explain why you cannot.)
APPLICANT*S EMPLOYMENT
& FINANCIAL INFORMATION
(????
)????每????
Total Annual Income2,3
$????????
2
3
limony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for
A
repaying this obligation.
Include all your income. See Main Source examples below. You also may include someone else*s income that*s regularly deposited into your account (joint with
them or individual). Age 21 and over: You also may include the portion of someone else*s income regularly used to pay your expenses.
Main Source of Total Annual Income (Select One):
Rental Income
Employment Income
Business Ownership/Sole Proprietorship
Pension/Retirement Income
Sale of Property
Government Program
Investments
Social Security
Inheritance
Trust Fund Disbursements
Other
Monthly Housing Payment
APPLICANT*S ACCT
RELATIONSHIP
INFORMATION
$????????????
Own
Other
Enter your total assets and length of relationship with this Financial Institution.
Combined Checking, Savings and Money Market Accounts Combined Investment and Retirement Accounts
$
$
Please provide the length of time, in years, that you have had a financial relationship with this Institution (if applicable): ???? Years
SEC STD 08/24
PLEASE ALSO COMPLETE PAGE 3 OF APPLICATION, INCLUDING SIGNATURE(S). SEE PAGE 3 FOR APPLICANT AGREEMENT.
Page 2 of 5
DO NOT FAX
FOR SECURITY PURPOSES, COMPLETED APPLICATIONS MAY NOT BE RETURNED VIA EMAIL
SECURED VISA? CREDIT CARD APPLICATION
SECURITY AGREEMENT
SIGNATURE
IMPORTANT TERMS AND
APPLICANT AGREEMENT
FOR WISCONSIN
RESIDENTS ONLY
Elan Location Code (Required)
If no Location Code indicated,
App can not be processed.
Married Wisconsin residents must provide the name and address of their spouse below. If this credit Account is opened, we may give notice of the opening to the applicant*s spouse.
I am
Unmarried
Married and the name of my spouse is
and my spouse resides at the:
address above or at:
By signing the application, you understand and agree that Elan Financial Services (※we,§ ※us§ or ※our§), as the creditor and issuer of your Account, will rely on the information provided here
in making this credit decision, and you certify that such information is accurate and complete to the best of your knowledge. If we open an Account based on this Application, you will be
individually liable for all authorized charges and for all fees referred to in the most recent Cardmember Agreement, which may be amended from time to time. We may request consumer credit
reports about you for evaluating this Application and in the future for reviewing Account credit limits, for Account renewal, for servicing and collection purposes and for other legitimate purposes
associated with your Account. Upon your request, we will inform you if a consumer report was requested and, if it was, provide you with the name and address of the consumer reporting
agency that furnished the report. By providing us with a telephone number for a cellular phone or other wireless device, including a number that you later convert to a cellular number, you are
expressly consenting to receiving communications - including but not limited to prerecorded or artificial voice message calls, text messages, and calls made by an automatic telephone dialing
system - from us and our affiliates and agents at that number. This express consent applies to each such telephone number that you provide to us now or in the future and permits such calls
for non-marketing purposes. Calls and messages may incur access fees from your cellular provider. By signing the application, you also agree that we may verify your employment, income,
address and all other information provided with other creditors, credit reporting agencies, employers, third parties and through records maintained by federal and state agencies (including any
state motor vehicle department) and waive any rights of confidentiality you may have in that information under applicable law. You agree that, in order to open and administer the Account that
may be established as a result of this Application, we and the correspondent financial institution that solicited this Application may share certain information about you and your ongoing Account
activity. By signing the application, you certify that you have read and understood the disclosures here and you agree to the terms of this Application, including all Secured Account disclosures.
By signing below, you certify that you have read and understood the disclosures here and you agree to the terms of the application.
Signature of Applicant
Date
X
??|??|
Secured Savings Account Application: In connection with my application for a Secured Visa? Card (the ※Credit Card Account§), I request that Elan Financial Services (※you§) establish a
Secured Savings Account* (※SSA§) for me as the Primary Applicant for the funding amount I have provided (approved check or electronically). I understand that the SSA will be subject to the terms
of a Secured Savings Account Agreement which will be provided to me, as may be revised from time to time. I agree that if I have funded the SSA with an approved check, (1) you will hold the
funds in trust for me without interest until the credit decision is made and that the SSA will be established with U.S. Bank National Association with the funds if my Credit Card Account application is
approved, and (2) if this Credit Card Account application is not approved you will return the full amount of the check to the Primary Applicant at the address shown on this application. I agree that
if I have funded the SSA electronically through an online application for the Credit Card Account, (1) I will ensure that the funding amount is in my funding account when I submit my application
until I receive your decision, (2) that I am a named account holder on the funding account and authorize the withdrawal, and (3) you will establish the SSA and the funds will be withdrawn if this
Credit Card Account application is approved. Funds from business accounts are not accepted. If the SSA is established, I understand that no withdrawals will be allowed from the SSA without your
consent, and if the Credit Card Account is closed, the funds will be used to pay the balance in full. I understand that the funds in the SSA will not be used to pay any Credit Card Account obligations
except when the Credit Card Account is closed. I agree that if the Credit Card Account is closed or I request a credit limit decrease, funds may be held for the later of (a) 60 days, or (b) two billing
cycles after the date the Credit Card Account is closed, or (c) two billing cycles after the last item is posted to the Credit Card Account, as described in the Secured Savings Account Agreement.
TIN Certification: Under penalties of perjury, I certify that (1) the number shown on this application is my correct taxpayer identification number and (2) I am not
subject to backup withholding because: a) I am exempt from backup withholding, or b) I have not been notified by the Internal Revenue Service (IRS) that I am
subject to backup withholding as a result of a failure to report all interest or dividends, or c) the IRS has notified me that I am no longer subject to backup withholding
and 3) I am a U.S. citizen or other U.S. person, and (4) the FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
I must cross out item 2 above if I have been notified by the IRS that I am currently subject to backup withholding because I have failed to report all interest and
dividends on my tax return.
Security Agreement: As a condition to obtaining a Secured Visa? Card (the ※Credit Card Account§), I hereby grant to U.S. Bank National Association (※you§) a security interest in, and assign and
transfer to you all rights, title, and interest in my Secured Savings Account (the ※SSA§) held at U.S. Bank National Association and all interest, additions, and proceeds therein to secure the payment and
performance of my obligations to you under the terms of the Credit Card Account Cardmember Agreement. I hereby instruct U.S. Bank National Association to open the designated SSA in the name of
※U.S. Bank 每
Secured Credit Card Collateral Account§
(Insert primary applicant*s name)
using the Primary Applicant*s name and Social Security Number or Taxpayer Identification Number provided on this application. I agree that while this security interest is in effect, you will have
the exclusive dominion and control and you will have the sole right and power to redeem, collect, and withdraw any part or the full amount of the SSA. If I am in default under the terms of my
Credit Card Account Cardmember Agreement, I agree that you will have all rights the law allows, including the right to take funds from the SSA and apply them to my Credit Card Account balance
without notice to, or further consent from, me. I understand and agree that, based upon your periodic review of my overall credit history (including this Credit Card Account and other credit cards
and loans), I may qualify to have the funds in the SSA released. I understand that if you determine that the funds from my SSA may be released, you will release the funds to the Cardmember(s)
and this Credit Card Account will no longer be a secured credit card account.
By signing below, I agree to the terms of the Secured Savings Account application, TIN Certification and Security Agreement, and I agree that all agreements between you and me will
be made when accepted or approved by you.
I understand that the Internal Revenue Service does not require my consent to any provision of this document other than the certifications required to avoid backup withholding.
SECURITY
AGREEMENT
SIGNATURE
*FDIC insured
By signing below, you certify that you have read and understood the disclosures here and you agree to the terms of the application.
Signature of Applicant
Date
X
??|??|
SEC STD 08/24
SEE PAGE 4 FOR MAILING INSTRUCTIONS.
Page 3 of 5
DO NOT FAX
FOR SECURITY PURPOSES, COMPLETED APPLICATIONS MAY NOT BE RETURNED VIA EMAIL
SECURED VISA? CREDIT CARD APPLICATION
If no Location Code indicated,
App can not be processed.
To be completed by the Financial Institution:
Employee Receiving Credit 每 Elan Location Code
Employee Receiving Credit 每 Officer ID
Employee Receiving Credit 每 Branch ID
(not Branch or ID number)
(eight characters max, alpha or numeric)
(your Branch number, nine characters max, alpha or numeric)
Employee Receiving Credit 每 First Name
Employee Receiving Credit 每 Last Name
Employee Receiving Credit 每 Phone Number
Employee Receiving Credit 每 Email Address
MAILING
INSTRUCTIONS
INTERNAL USE ONLY
Elan Location Code (Required)
SEC STD 08/24
APPLICANT: If you are unable to complete this application with the Representative, please
place your check and the completed application (pages 2, 3 and 4) in an envelope and mail it
to the address below.
MAIL TO:
DO NOT FAX
S
ecured Card Processing
PO Box 6363
Fargo, ND 58125-6363
REMINDER 每 Must mail in cashier*s check/money order with application.
Page 4 of 5
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities,
Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. What this means for you: When you open an account, we
will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver*s license or other identifying documents.
Summary Of Visa Account Terms
Interest Rates and Interest Charges
Visa? Max Cash Secured Card
Secured Visa? Card
Annual Percentage Rate (APR) for
Purchases
This APR will vary with the market based on the Prime Rate.
This APR will vary with the market based on the Prime Rate.
29.99%
29.24%
APR for Balance Transfers
29.99%
29.24%
This APR will vary with the market based on the Prime Rate.
This APR will vary with the market based on the Prime Rate.
APR for Cash Advances
29.99% This APR will vary with the market based on the Prime Rate.
Penalty APR and When It Applies
Not Applicable.
How to Avoid Paying Interest on
Your due date is 24-30 days after the close of each billing cycle. We will not charge you interest on purchases if you pay your entire balance
Purchases
by the due date each month.
Minimum Interest Charge
If you are charged interest, the charge will be no less than $1.00.
For Credit Card Tips from the Consumer To learn more about factors to consider when applying for or using a credit card, visit the website of the
Financial Protection Bureau
Consumer Financial Protection Bureau at .
Fees
Annual Fee
None
Transaction Fees
Either 3% of the amount of each transfer or $5 minimum, whichever is greater
? Balance Transfer
Either 3% of the amount of each advance or $5 minimum, whichever is greater
? Convenience Check Cash Advance1
? Cash Advance
Either 5% of the amount of each advance or $10 minimum, whichever is greater
? Cash Equivalent Advance
Either 5% of the amount of each advance or $10 minimum, whichever is greater
? Overdraft Protection2
$10 per occurrence
? Foreign Transaction
3% of each foreign purchase transaction or foreign ATM advance transaction.
Penalty Fees
? Late Payment
Up to $41
? Returned Payment
Up to $41
? Overlimit
None
How We Will Calculate Your Balance: We use a method called ※average daily balance Security Number Verification: In connection with your application for this account and
(including new purchases).§
by submitting this application, you authorize the Social Security Administration (SSA) to verify
Contact For Updates: The information about the costs of the card described in this and disclose to us through Early Warning Services, LLC, our service provider, whether the name,
application is accurate as of July 26, 2024. This information may have changed after that date. Social Security Number (SSN) and date of birth you have submitted matches information in SSA
To find out what may have changed, call us at 800.558.3424 (we accept relay calls) or write records. This one-time consent is valid for the next 90 days.
us at PO Box 6354, Fargo, ND 58125-6354.
Balance Transfer Information: Balance transfer transactions from other Elan Financial
1
These products do not receive convenience checks.
Services accounts are not permitted. You may cancel a balance transfer request within 10 days
2
Not all products/financial institutions offer Overdraft Protection.
of account opening by calling 800-285-8585. After 10 days from account opening, requests
Right to Change Terms: Elan Financial Services may change APRs, fees and other Account to stop payment on Balance Transfer Check(s) issued by Elan shall not be honored unless the
terms in the future based on your experience with it and with its affiliates as provided under the check(s) has been stolen, lost or destroyed.
Cardmember Agreement and applicable law.
Rewards Program Rules for the Max Cash Secured Card: Rewards are earned
How Variable Interest Rates Are Determined: Your interest rate is a variable rate on eligible net purchases. Net purchases are purchases minus credits and returns. Not all
and is determined by a combination of the Prime Rate (which may vary) added to a margin transactions are considered to be Purchases and eligible to earn rewards, such as transactions
(which does not change). Because the Prime Rate may vary, your variable interest rate will go posting as Convenience Checks; Balance Transfers; Advances (including ATM withdrawals, wire
up or down if the Prime Rate changes. If you are granted an Account, the following rates on the transfers, traveler*s checks, money orders, foreign cash transactions, betting transactions, and
Account are variable: Non-Introductory Purchase Rate; Non-Introductory Balance Transfer Rate; lottery tickets); interest charges and fees; credit insurance premiums; and transactions to (i) fund
Cash Advance Rate. More information is available in the Cardmember Agreement.
certain prepaid card products, (ii) buy currency from the U.S. Mint, or (iii) buy cash convertible
Notice to New York Residents: You may contact the New York State Department of items. Upon approval, see your Cardmember Agreement for details. Subject to applicable law,
Financial Services by telephone at (800) 342-3736 or visit its website at dfs. for you may not redeem rewards, and you will immediately lose all of your rewards, if your Account
free information on comparative credit card rates, fees and interest-free periods.
is closed to future transactions (including, but not limited to, due to Program misuse, failure to
Notice to Married Wisconsin Residents: No provision of any marital property pay, bankruptcy, or death). Cash rewards can be redeemed as a deposit to a checking or savings
agreement, unilateral statement under section 766.59 of the Wisconsin statutes or court decree account with this Financial Institution only, which will be deposited within seven business days,
under section 766.70, adversely affects our interest unless we, prior to the time the credit is or as a statement credit to your credit card account, which will be deposited within one to two
granted or an open-end credit plan is entered into, are furnished a copy of the agreement, decree billing cycles or as a Rewards Card ($25 minimum redemption). Cardmember must initially
or court order or have actual knowledge of the adverse provisions. IF YOU ARE A MARRIED enroll into categories of their choice, or all net purchases will earn no more than 1% cash back.
WISCONSIN RESIDENT, CREDIT EXTENDED UNDER THIS ACCOUNT WILL BE INCURRED IN THE Categories are subject to change. You will earn 5% cash back on your first $2,000 in combined
INTEREST OF YOUR MARRIAGE OR FAMILY.
net purchases each calendar quarter in your two chosen 5% categories and unlimited cash back
Notice to California Residents: An applicant, if married, may apply for a separate Account. in your 2% category. All other net purchases earn 1% cash back. Transactions qualify for 5% or
Notice to Ohio Residents: The Ohio laws against discrimination require that all creditors 2% cash back based on how merchants classify the transaction. Upon approval, full details will
make credit equally available to all creditworthy customers, and that credit reporting agencies be provided in your Cardmember Agreement. Cash rewards do not expire as long as the account
maintain separate credit histories on each individual upon request. The Ohio Civil Rights remains active. If there is no reward, purchase, or balance activity on your account for 12
Commission administers compliance with this law.
statement cycles, your cash rewards balance will expire. The Elan Rewards Program is subject to
Authorization for the Social Security Administration to Disclose Your Social change. Rewards are administered by a third party.
The creditor and issuer of these credit cards is Elan Financial Services, pursuant to a license from Visa U.S.A. Inc.
?2024 Elan Financial Services. All rights reserved.
THIS PAGE IS FOR THE APPLICANT TO RETAIN FOR THEIR RECORDS.
SEC STD 08/24
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