Fillable McCoy Federal Credit Union COMMERCIAL CREDIT CARD APPLICATION

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McCoy Federal Credit Union COMMERCIAL CREDIT CARD APPLICATION

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BUSINESS YEAR END
YEAR ESTABLISHED
NATURE OF BUSINESS
IF INDIVIDUAL, DATE OF BIRTH IF INDIVIDUAL, NAME AND PHONE NO. OF EMPLOYER
COMMERCIAL CREDIT CARD APPLICATION
A. COMPANY INFORMATION
CONTACT NAME
STREET ADDRESS
LEGAL NAME OF BUSINESS
page 1 of 4
MAILING ADDRESS
PHONE NUMBER
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 you for your name, street 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.
PHONE NUMBER E-MAILFAX
TAX ID NO. TYPE OF ENTITYSTATE
LASER USR FI13406 Rev 4-2011
COPYRIGHT 2005 by Credit Union Resources & Educational Services, LLC. All rights reserved.
Distributed with permission by Securian Financial Group, Inc.
McCoy Federal Credit Union
P.O. Box 593806
Orlando, FL 32859-3806
(407) 855-5452
Toll Free (888) 584-7701
DATE
B. FINANCIAL INFORMATION
IF YES, DESCRIBE: ACCOUNTANT OR ACCOUNTING FIRM:
TAX RETURN FILED THROUGH WHAT DATE:
NAME(S) AND TITLE(S) OF PERSONS AUTHORIZED TO BORROW MONEY ON BEHALF OF THE BUSINESS:
FINANCIAL STATEMENT ON BORROWER(S) SUBMITTED WITH APPLICATION
DATE
DATE
DATE
Are any returns being contested or audited: YES NO
TAX RETURN ON GUARANTOR(S) SUBMITTED WITH APPLICATION
1. 2.
3. 4.
FINANCIAL STATEMENT ON GUARANTOR(S) SUBMITTED WITH APPLICATION
TAX RETURN ON BORROWER SUBMITTED WITH APPLICATION
C. GUARANTOR/CO-BORROWER (REQUIRED FOR ANY PERSON WITH AN OWNERSHIP INTEREST IN THE COMPANY)
CHECK HERE IF ADDITIONAL GUARANTORS/CO-BORROWERS INFORMATION IS ATTACHED ON PAGE 3
NAME TAX ID NUMBER
STREET ADDRESS
FAX NUMBER
DATE OF BIRTH
MAILING ADDRESS (IF DIFFERENT)
HOME NUMBER WORK NUMBER E-MAIL
NAME TAX ID NUMBER
STREET ADDRESS
FAX NUMBER
DATE OF BIRTH
MAILING ADDRESS (IF DIFFERENT)
HOME NUMBER WORK NUMBER E-MAIL
page 2 of 4
This information and the information provided on all accompanying financial statements and schedules is provided for the purpose of obtaining credit for the
Applicant(s) or for the purpose of Applicant(s) guaranteeing credit for others. Applicant(s) acknowledge that representations made in this application will be
relied on by Creditor in its decision to grant such credit. This application is true and correct in every detail and accurately represents the financial condition of
the Applicant(s) on the date given below. Creditor is authorized to make all inquiries it deems necessary, either directly or through any agency employed by
Lender for that purpose, to verify the accuracy of the information contained herein and to determine the creditworthiness of the Applicant(s). Applicant(s) will
promptly notify Creditor of any subsequent changes which would affect the accuracy of this application. Creditor is further authorized to answer any questions
about Creditor's credit experience with Applicant(s). Applicant(s) are aware that any knowing or willful false statements regarding the application for purposes
of influencing the actions of Creditor can be a violation of federal law, 18 U.S.C. & 1014, and may result in a fine or imprisonment or both.
SIGNATURES
STATEMENT OF BUSINESS PURPOSE: The undersigned represent, warrant and guaranty that the loan requested via the application and or other
documentation submitted contemporaneously herewith is for commercial use, and: (1) no part of the loan or its proceeds; (2) no property, equipment or
other goods acquired with loan proceeds or used in the business of the borrowers or any guarantors or otherwise will be used for any consumer,
household or family purpose whatsoever. By signing below, each Applicant declares that he/she has read and understands this Statement and individually
represents, warrants and guarantees as set forth with the expectation that the Credit Union will rely on this Statement.
By signing below, each Applicant declares that he/she has read and understands the Notices Addendum attached as page 4 and, if applicable, has received
the Reg B notification regarding denied credit contained therein.
SIGNATURESIGNATURE DATE
BY:
TITLE:
X
DATE
BY:
TITLE:
X
SIGNATURE
SIGNATURE DATE
INDIVIDUAL NAME:
X
DATE
INDIVIDUAL NAME:
X
JOINT CREDIT: TO BE COMPLETED BY ALL NATURAL PERSONS SIGNING INDIVIDUALLY AS BORROWERS, CO-BORROWERS
OR GUARANTORS:
Joint Credit -- We intend to apply for joint credit. (initials)
AS CO-APPLICANT/GUARANTOR
SIGNATURE
AS CO-APPLICANT/GUARANTOR
DATE
SIGNATURE DATE
INDIVIDUAL NAME:
X
INDIVIDUAL NAME:
X
D. CARDHOLDER & CREDIT LIMIT INFORMATION
Please provide the names of the individuals to be issued cards and the corresponding credit limits requested. If more than 5 cards will be issued, continue below.
1. NAME: FIRST, MI, LAST
4. NAME: FIRST, MI, LAST
3. NAME: FIRST, MI, LAST
2. NAME: FIRST, MI, LAST CREDIT LIMIT REQUESTED
CREDIT LIMIT REQUESTED
$
TOTAL CREDIT LIMIT REQUESTED (for all cards):
(The total of all individual card limits bust be equal to, or less than, this amount):
5. NAME: FIRST, MI, LAST
$
SOCIAL SECURITY NO.
SOCIAL SECURITY NO.
$
AS CO-APPLICANT/GUARANTOR
CREDIT LIMIT REQUESTED
$
SOCIAL SECURITY NO.
CREDIT LIMIT REQUESTED
$
SOCIAL SECURITY NO.
CREDIT LIMIT REQUESTED
$
SOCIAL SECURITY NO.
AS CO-APPLICANT/GUARANTOR
ADDITIONAL CARDHOLDER & CREDIT LIMIT INFORMATION
6. NAME: FIRST, MI, LAST
9. NAME: FIRST, MI, LAST
8. NAME: FIRST, MI, LAST
7. NAME: FIRST, MI, LAST CREDIT LIMIT REQUESTED
CREDIT LIMIT REQUESTED
$
10. NAME: FIRST, MI, LAST
$
SOCIAL SECURITY NO.
SOCIAL SECURITY NO.
CREDIT LIMIT REQUESTED
$
SOCIAL SECURITY NO.
CREDIT LIMIT REQUESTED
$
SOCIAL SECURITY NO.
CREDIT LIMIT REQUESTED
$
SOCIAL SECURITY NO.
11. NAME: FIRST, MI, LAST
13. NAME: FIRST, MI, LAST
12. NAME: FIRST, MI, LAST CREDIT LIMIT REQUESTED
CREDIT LIMIT REQUESTED
$
$
SOCIAL SECURITY NO.
SOCIAL SECURITY NO.
CREDIT LIMIT REQUESTED
$
SOCIAL SECURITY NO.
LEGAL NAME OF BUSINESS DATE
NAME TAX ID NUMBER
STREET ADDRESS
GUARANTOR/CO-BORROWER (REQUIRED FOR LOANS TO ENTITIES AND GROUPS SUCH AS A CORPORATION)
FAX NUMBER
DATE OF BIRTH
MAILING ADDRESS (IF DIFFERENT)
HOME NUMBER WORK NUMBER E-MAIL
NAME
AS CO-BORROWER/GUARANTOR:
NAME
TAX ID NUMBER
ADDITIONAL GUARANTORS/CO-BORROWERS -
COMMERCIAL CREDIT CARD APPLICATION
STREET ADDRESS
FAX NUMBER
DATE OF BIRTH
MAILING ADDRESS (IF DIFFERENT)
HOME NUMBER WORK NUMBER
TAX ID NUMBER
STREET ADDRESS
FAX NUMBER
DATE OF BIRTH
MAILING ADDRESS (IF DIFFERENT)
HOME NUMBER WORK NUMBER
E-MAIL
In addition to those Guarantors/Co-Borrowers noted on page 1 of this Application, we submit the following additional Guarantor/Co-Borrower information:
E-MAIL
NAME TAX ID NUMBER
STREET ADDRESS
FAX NUMBER
DATE OF BIRTH
MAILING ADDRESS (IF DIFFERENT)
HOME NUMBER WORK NUMBER E-MAIL
page 3 of 4
AS CO-BORROWER/GUARANTOR:
PAGE 4: APPLICANT COPY OF NOTICES ADDENDUM TO COMMERCIAL CREDIT CARD APPLICATION (TO BE RETAINED BY APPLICANT)
Check as applicable: There are no additional Guarantors/Co-Borrowers other than those listed on page 1 of this Application.
There are additional Guarantors/Co-Borrowers. See Below:
McCoy Federal Credit Union
P.O. Box 593806
Orlando, FL 32859-3806
(407) 855-5452
Toll Free (888) 584-7701
AS CO-BORROWER/GUARANTOR:
AS CO-BORROWER/GUARANTOR:
SIGNATURE
SIGNATURE
DATE
DATE
X
X
SIGNATURE DATE
X
SIGNATURE DATE
X
within 60 days from the date that you were notified of our decision. We will send you a written statement of reasons for the denial within 30 days of receiving
your request. The notice below describes additional protections extended to you.
NOTICE: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion,
national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income
derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The
federal agency that administers compliance with this law concerning this creditor is:
page 4 of 4
EQUAL CREDIT OPPORTUNITY ACT NOTICES
If your gross annual revenues in the previous fiscal year were $1,000,000.00 or less, and your application is denied, you have the right to receive a written
statement of the specific reasons for this denial. To obtain the statement, please contact:
NOTICES ADDENDUM TO
COMMERCIAL CREDIT CARD APPLICATION
APPLICANT COPY - DETACH AND KEEP FOR YOUR RECORDS
McCoy Federal Credit Union
P.O. Box 593806
Orlando, FL 32859-3806
STATE NOTICES
OHIO RESIDENTS ONLY: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that
credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with
this law.
WISCONSIN RESIDENTS: Marital Status: Married Unmarried Legally Separated
If married: the name of my spouse is
Spouse's SSN: Spouse's Address (if different)
Notice: No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 766.70 will adversely
affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its
terms, before the credit is granted or the account is opened.
X
MARRIED WISCONSIN RESIDENTS APPLYING FOR AN INDIVIDUAL ACCOUNT: By signing here, I state that the credit being applied for, if granted,
will be incurred in the interest of the marriage or family of the Borrower(s).
National Credit Union Administration, Office of Consumer Protection, 1775 Duke Street, Alexandria, VA 22314. Phone - (703) 518-1140; Fax - (703)
518-6672.
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McCoy Federal Credit Union COMMERCIAL CREDIT CARD APPLICATION

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Completed 31 January 2022

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