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VISA Credit Card Application

Membership Eligibility

At Golden Plains Credit Union, anyone who lives, works or worships in Central, Western or Southeast Kansas, the Liberal trade area, members of their family, employees of the credit union, members of the Friends of Lee Richardson Zoo and the Leave a Legacy Foundation, and organizations of such persons are eligible for membership.

VISA Credit Card Agreement & Disclosures

* - Indicates required field

Type of Credit

Check below to indicate the type of credit for which you are applying

Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if:

  1. you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI);
  2. your spouse will use the account, or
  3. you are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support or separate maintenance, complete the Other section to the extent possible about the person on whose income you are relying.

Joint Credit: If you are applying with another person, complete the Applicant and Other sections.

$
$

Primary Applicant

Personal Information

Own or Rent?
$
Complete for joint credit, secured credit or if you live in a community property state

Employment/Income

Notice: Alimony, child support or separate maintenance income need not be revealed if you do not choose to have it considered.

$
$

Other Information

1) Are you a U.S. citizen?
2) Are you a permanent resident alien?
3) Do you currently have any outstanding judgements or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under Chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been party in a lawsuit?
4) Are you a co-maker, co-signer or guarantor on any loan(s)?
(If "YES", please complete Questions 4a through 4c.)
(Name of Others Obligated on Loan)
(Name of Creditor)
$
(Monthly Payment)

Joint Applicant

Personal Information

Type of Applicant
Own or Rent?
$
Complete for joint credit, secured credit or if you live in a community property state

Employment/Income

Notice: Alimony, child support or separate maintenance income need not be revealed if you do not choose to have it considered.

$
$

Other Information

1) Are you a U.S. citizen?
2) Are you a permanent resident alien?
3) Do you currently have any outstanding judgements or have you ever filed for bankruptcy, had a debt adjustment plan confirmed under Chapter 13, had property foreclosed upon or repossessed in the last 7 years, or been party in a lawsuit?
4) Are you a co-maker, co-signer or guarantor on any loan(s)?
(If "YES", please complete Questions 4a through 4c.)
(Name of Others Obligated on Loan)
(Name of Creditor)
$
(Monthly Payment)

Personal Reference

Finishing Up

User Agreements

Primary Applicant: You promise that everything that you have stated in this application is correct to the best of your knowledge. If there are any important changes you will notify us in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this application of credit and for any update, increase, renewal, extension, or collection of the credit received. You understand that the Credit Union will rely on the information in this application and your credit report to make its decision. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan applications made to federal credit unions or state chartered credit unions insured by NCUA.

Other Applicant: You understand that the use of your card will constitute acknowledgement of receipt and agreement to the terms of the credit card agreement. A condition of your account is your granting us a security interest in all individual and joint share and/or deposit accounts you have with us now and in the future to secure your credit card account. Shares and deposits in an Individual Retirement Account and any other account that would lose special tax treatment under state or federal law if given as security are not subject to this security interest. When you are in default we may apply the balance in these accounts to any amounts due under the credit card agreement.

Account Disclosures

View the Account Disclosures

E-Sign Act

View the E-Sign disclosure

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