Secure VISA Application and Information

Are you a Member of Rockland Federal Credit Union?

	Yes, I am a member of Rockland Federal Credit Union
	I am not a member, but I live in Barnstable, Bristol, Middlesex, Norfolk, Plymouth or Suffolk Counties
	I am not a member, but I work in Barnstable, Bristol, Middlesex, Norfolk, Plymouth or Suffolk Counties Employer City:
	I am an immediate family member of an eligible or current member

If you are not currently a member of RFCU, and qualify to be a member, you will be required to open a $5.00 savings or checking account prior to or at the closing of your loan. You are welcome to apply for a loan now. To open an account and join Rockland Federal Credit Union please go to the Membership section on our Home Page for more information.

To apply, submit the secure online application below.

Visa Classic or Visa Platinum?
How many applicants?	Individual Joint
Credit Line Requested?
This is a request to increase an existing RFCU Visa Classic or Visa Platinum account.

Application Information

All fields with an asterisk (*) indicate required fields that must be completed before submitting your application

* First Name
Middle Initial
* Last Name
* Date of Birth (MM/DD/YYYY)		/ /
* Social Security Number
* Work Phone Number
* Home Phone Number
* E-mail Address
* Residential Address
* City
* State
* Zip Code
Mailing Address If different
City
State
Zip Code
* Years at Current Address
* Residential Status		Own Rent With Family Other
* Rent or Mortgage Payment
Are you currently Employed?		Yes No
* Employer's Name
* Job Title or Occupation
Years at Current Employer
* Gross Annual Salary
* Are You a U.S. Citizen?		Yes No
Other Source of Income
Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repayment of this loan.
Description
Gross Annual Amount
Joint Applicant Information
If this loan application is a joint request for credit, the co-applicant must indicate by checking the Yes box below, that it is his/her intent to be a co-applicant and the information provided will be used on this credit request. Yes No*
*	First Name
	Middle Initial
*	Last Name
*	Date of Birth (MM/DD/YYYY)	/ /
*	Social Security Number
* Work Phone Number
* Home Phone Number
*	E-mail Address
*	Residential Address
*	City
*	State
*	Zip Code
Mailing Address If different
City
State
Zip Code
*	Years at Current Address
*	Residential Status	Own Rent With Family Other
* Rent or Mortgage Payment
* Employer's Name
* Job Title or Occupation
	Years at Current Employer
*	Gross Annual Salary
* Are You a U.S. Citizen?		Yes No
	Other Source of Income
	Description
	Gross Annual Amount
	Please note: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repayment of this loan.

Comments/Other Information

VISA DISCLOSURE INFORMATION

Interest Rates and Interest Charges
Platinum Visa
Annual Percentage Rate (APR) for Purchases, Cash Advances and Balance Transfers (as of 12/01/09)	9.90%
Classic Visa
Annual Percentage Rate (APR) for Purchases and Cash Advances (as of 12/1/09)	13.90%
Annual Percentage Rate (APR) for Balance Transfers (as of 12/1/09)	8.90%
How to avoid paying interest on Purchases (Platinum and Classic)	You will have a minimum of 28 days without a finance charge on new purchases if the total New Balance due is paid in full each month by the payment due date on your next periodic billing statement.
Maximum APR	18.00%
Minimum Interest Charge	None
For Credit Card Tips from the Consumer Financial Protection Bureau	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.
Fees (Platinum and Classic)
Set Up and Maintenance Fees Annual Fee Replacement Card Fee Rush Card Fee	None $5.00 $25.00
Transaction Fees Balance Transfer Fee Cash Advance Fee Foreign Transaction Fee Stop Payment on Convenience Check Fee	None None Effective April 1, 2008 a fee of up to 1% of the transaction amount posted to your account will be imposed on all foreign transactions made in a foreign currency, including purchases, cash withdrawals, or cash advances. A fee of 0.8% of the transaction amount posted to your account will be imposed on all foreign transactions made in U.S. dollars, including purchases, cash withdrawals, or cash advances. A foreign transaction is any transaction that you complete or a merchant completes on your card and the cardholder's country is different than the merchant country excluding Puerto Rico, or the US Virgin Islands. This foreign fee will be posted as a separate transaction on your statement. $28.00
Penalty Fees Late Payment Fee Returned Convenience Check Fee	Up to $25.00 $28.00

How We Will Calculate Your Balance: We use a method called "average daily balance (including new purchases)."

Other information may be required to complete your application, including income verification. Please note that we may report information about your account to credit bureaus. Late payments, missed payments, or other defaults on your account may be reflected in your credit report.
By clicking "Submit" below:
I/we promise all information given on this application is correct to the best of my/our knowledge.
And
I/we authorize Rockland Federal Credit Union to check my/our credit and employment history and to answer questions about your credit experence with me/us.
The information you send to RFCU on this form will be encrypted for your privacy and protection

Privacy and Security Statement

To Be Completed At Time of Closing

Signature of Applicant(s)
All joint applicants must sign.
Everything that I/We have stated in this application is correct to the best of my/our knowledge. I/We understand that you will retain this application whether or not it is approved. You are authorized to check my/our credit and employment history and to answer questions about your credit experience with me/us.

We intend to apply for joint credit	___________________ APPLICANT INITIALS	_____________________ CO-APPLICANT INITIALS

______________________________________________________________________
Signature of Applicant	Date
______________________________________________________________________
Signature of Co-Applicant	Date