Midwest
Operating Engineers Credit Union
6240 Joliet Road
Countryside, IL 60525-3992
Type
of Account Desired:
Individual Account
Joint Account
Individual Account
with Authorized User
Social
Security Number:
Authorized
Users Signature:
**Please
Note: If you are applying for credit in your name only, do not complete
portion on co-applicant.
APPLICANT
CO-APPLICANT
Name
(First-Last-MI)
Name
(First-Last-MI)
Home
Address (Street & No.)
Home
Address (Street & No.)
City-State-Zip
-
City-State-Zip
-
Home
Phone
Birth Date
Home
Phone
Birth
Date
No.
of Dependents
Ages
No.
of Dependents
Ages
Driver's
License No. & State
Driver's
License No. & State
Gross
Annual Salary
Gross
Annual Salary
SSN
Employer
Employer
Position
How
Long?
Position
How
Long?
Business
Phone/Beeper Number
Business
Phone/Beeper Number
Union
Registration Number
Union
Registration Number
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 repaying
this obligation.
Other
income:
per
Other
income:
per
Source(s)
of other income
Source(s)
of other income
Is
any of this income likely to be reduced in the next two years?
Yes (Explain detail on a separate sheet)
No
Is
any of this income likely to be reduced in the next two years?
Yes (Explain detail on a separate sheet)
No
Outstanding
Debts
(Include charge accounts, installment contracts, credit cards, rent,
mortgages, etc. Use separate sheet if necessary.)
Mortgage
Payment
Rent
Payment
Original
Amount
Balance
Monthly
Payment
Autos
Owned-Make
Year
Financed
By
$
$
$
Autos
Owned-Make
Year
Financed
By
$
$
$
Name,
Address, and Account No. (Other Debts)
Interest
Rate
$
$
$
$
$
$
$
$
$
Checking/Share
Draft Account No.
Savings/Share
Account No.
Total
$
Location
Location
Name
of Nearest Relative Not Living with You
Address
(Street-City-State-Zip)
-
Phone #
Relationship
Complete
the following only if you reside in a community property state (Arizona,
California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington,
or Wisconsin); or if another person will be jointly liable on the
account.
Married
Separated
Unmarried
The
information about the costs of the card described in this application
is accurate as of April 1995. This information may have changed after
that date. To find out what may have changed, call us at the above
telephone number or write us at the above address.
Credit
Disclosure
Minimum
payment
3%
or $20.00
(whichever is greater)
Annual
percentage rate for purchases
12.0%
Minimum
finance charge
NONE
Grace
period for repayment of balances for purchases
25
days
Transaction
fee for purchases
NONE
Method
of computing the balance for purchases
Average
daily balance
(including current transactions)
This
statement is submitted to obtain credit and I/(We) certify that all
information herein is true and complete. I/(We) also authorize the
credit union to verify or obtain further information the credit union
may deem necessary concerning my/(our) credit standing. If this application
is approved and a credit card(s) issued, the undersigned applicant(s)
by signing, using or permitting another to use the credit card(s)
agree(s) that the applicant(s) will be bound by the terms and conditions
of the VISA agreement which will be furnished to me/(us).
APPLICANT'S
SIGNATURE AND
DATE
(Required)
___________________________________________
CO-APPLICANT'S
SIGNATURE AND
DATE
(Required if applicable)
_________________________________________
ATTENTION
LOCAL 150 MEMBERS:
This Section must be signed before VISA Card will be issued.
VACATION SAVINGS
Transfer Authorization Letter of Direction
I, hereby
authorize and direct you to transfer all amounts contributed on my behalf
to the Local 150, I.U.O.E. Vacation Savings Plan, when payable together
with so much of the earnings thereon as determined payable to me by the
Trustees, to my share account in the Midwest Operating Engineers Credit
Union.
I understand that this authorization shall remain in effect until revoked
by me by providing written notice to the Trustees of the Local 150, I.U.O.E.
Vacation Savings Plan and the Midwest Operating Engineers Credit Union,
except as otherwise provided below.
I agree that in the
event I have any financial obligation due and owing the Midwest Operating
Engineers Credit Union, you will transfer my Vacation Savings Plan account
to the Midwest Operating engineers Credit Union, and I waive any right
of revocation of this Transfer Authorization until such time as I no longer
have any financial obligation due and owing the aforesaid Credit Union.
I hereby covenant that I will not sue or make any claim against the Trustees
of the Local 150, I.U.O.E. Vacation Savings Plan either individually or
as Trustees aforesaid on account of any action taken by the Trustees hereunder.
I further agree that this Transfer Authorization may be pleaded as a defense
in any action proceeding brought against the Trustees by me or anyone
acting through me in breach of this covenant.
APPLICANTS SIGNATURE AND DATE
(Required)
X________________________________________
Pledge
Of Shares
Insurance
Options
By signing below,
you pledge to us (Midwest Operating Engineers Credit Union) and
grant us a security interest in all of your shareholdings with us
including paid shares and future payments on shares, to secure your
credit card account with us. You authorized us to apply these shareholdings
to pay any amounts due on the account under this agreement if you
should default.
Applicant's
Signature
(Required)
X__________________________
Co-Applicant's
Signature (Required
if applicable)
X__________________________
I am interested
in receiving information about Credit Life and/or Disability Insurance
on my VISA account.
I am NOT interested in receiving information about Credit Life and/or
Disability Insurance on my VISA account.