Visa® Credit Card Application

Important

"*" indicates required fields

Type of Account

Applicant Info:

First Name*

Middle Name

Last Name*

Suffix

Social Security Number*

Email*

Date of Birth*

Address Line 1*

Address Line 2

Housing Status

Monthly Housing Payment*

City*

State*

Zip*

Home Phone

Mobile Phone

Applicant Income & Employment information:

Employment Status*

Total Annual Income $*

Source of Annual Income

Name of Employer

Employer Phone Number

# of Years Employed by Employer

Second Applicant Info:

First Name*

Middle Name

Last Name*

Suffix

Social Security Number*

Email*

Date of Birth*

Address Line 1*

Address Line 2

Housing Status

Monthly Housing Payment*

City*

State*

Zip*

Home Phone

Mobile Phone

Second Applicant Income & Employment information:

Employment Status*

Total Annual Income $*

Source of Annual Income

Name of Employer

Employer Phone Number

# of Years Employed by Employer

Authorized User Information:

Applicant warning

By checking this box, applicant understands that authorized users receive full access to the account’s credit line, however, they are not legally responsible for paying any balance or associated fees that result from their use. Only the primary accountholder receives the bill, regardless of who made the charges.

First Name*

Middle Name

Last Name*

Social Security Number*

First Name*

Middle Name

Last Name*

Social Security Number*

Terms and Conditions:

Annual Percentage Rate (APR) for Purchases 13.00% The APR will vary with the market based on the Prime Rate
APR for Balance Transfers 13.00% The APR will vary with the market based on the Prime Rate
APR for Cash Advances 13.00% The APR will vary with the market based on the Prime Rate
Penalty APR 17.00% This APR will vary with the market based on the Prime Rate.
When Penalty APR Applies This APR will vary with the market based on the Prime Rate. This APR may be applied to you if you make a late payment – 60 days late
How long will the penalty APR apply? If your APRs are increased for this reason, the penalty APR will apply until you make six consecutive minimum payments when due.
How to Avoid Paying Interest on Purchases Your due date is at least 25 days after the close of each billing cycle.
We will not charge you interest on purchases if you pay your entire balance by the due date (Grace Period) each month. We begin charging interest on cash advances and balance transfers on the transaction date.
Minimum Interest Charge There is no minimum interest charge.
For Credit Card Tips form the Consumer Financial Protection Bureau To learn more about factors to consider when applying for or using a credit card, visit the web site of the Consumer Financial Protection Bureau.
Please see other fees on our Disclosure Information page - https://www.pennsvillenb.com/rates/disclosure-information

By clicking submit, you acknowledge and agree to the Terms and Conditions.

Acceptance*

Yes, I accept all terms and conditions displayed on this page and anywhere else on this website.

Authorization*

I authorize Pennsville National Bank to obtain a copy of my current credit report as a condition of acceptance of this application and for the purpose of extension or renewal of credit.

Yes

Certify*

I certify that the facts contained in this application are true and complete to the best of my knowledge and agree that completing this form does not obligate Pennsville National Bank to extend credit.

Yes

IMPORTANT ACCOUNT OPENING INFORMATION:
Federal Law requires us to obtain sufficient information to verify your identity. You may be asked several questions and to provide one or more forms of identification to fulfill this requirement. In some instances, we may use outside sources to confirm the information. The information you provide is protected by our privacy policy and federal law.

How did you hear about our Visa Credit Card?*

Other

Name

This field is for validation purposes and should be left unchanged.

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