Online VISA App

BSE VISA Application

Please complete the information on this application to apply for any type of loan. All information is required in order to process your application.

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After you have completed the form, press the "Submit Application" button to send your application. Our website is protected by the VeriSign, an internet security provider.

Once your application is received at the credit union, a Loan Officer will contact you for additional information. Income verification will be required.
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.

BSE CU Visa® Classic
Annual Percentage Rate (APR) for Purchases	10.99%
APR for Balance Transfers	10.99%
APR for Cash Transfers	10.99%
Grace Period on Purchases	25 Days
Method of Computing Balances	Average Daily Balance Method
Annual Fee	NONE
Minimum Finance Charge	NONE
Over the Credit Limit Fee	$25
Late Payment Fee	$25
Balance Transfer Fee	$25
Return Convenience Check Fee	$15

The information about the costs of the card described in the application is accurate as of January 2007. This information may have changed after that date. To find out what may have changed, please contact us.

Online VISA Application

Required Field

Will you be applying for Individual or Joint Credit Card?

If applying for a joint credit card, please read below to verify that you intend to apply for a joint credit card:

By checking this box, I acknowledge that I'm the joint applicant on this credit card application.

Martial Status: Complete marital status if this credit card is for joint or secured credit.

Applicant Information

Credit Limit

Last Name

First Name

Initial

Social Security Number

Birthdate
00/00/19??

Home Phone
w/Area Code

Driver's License #

Current Home Address

City

State

Zip Code

Own/Rent

Monthly Rent/Mortgage

Years at Address

Previous Address
(If less than 5 years at current residence.)

Previous Home Address

City

State

Zip Code

Number of Dependents

E-mail Address
(Required)

Please list one personal reference
(can be a family member) who does not live with you.

Name

Relationship

Phone No.

Address

City

State	Zip Code

Do you have a Savings Account?

If yes, where?

Savings Account Number

Do you have a Checking Account?

If yes, where?

Checking Account Number

Are you a U.S. Citizen or permanent alien?

Do you currently have any outstanding judgments 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 a party in a lawsuit?

Is your income likely to decline in the next two years?

Are you a co-maker, co-signer or guarantor on any loan not listed above?

If yes, list the name of others obligated on loan and the name of the creditor.

Are you responsible for alimony or child support?
Alimony or child support does not need to be disclosed if it is not applicable to this loan application.

Employer Information (Applicant)

Employer Name

Position

Hire Date

Employer Address		Work Phone w/Area Code
City		State	Zip Code
Monthly Gross Wages	Other Income & Source		Supervisor's Name
Previous Employer	How long at previous employer?		Position

Co-Applicant Information

Last Name

First Name

Initial

Social Security Number

Birthdate 00/00/19??

Home Phone w/Area Code

Driver's License #

Current Home Address

City

State

Zip Code

Own/Rent

Monthly Rent/Mortgage

Years at Address

Previous Address
(If less than 5 years at current residence.)

Previous Home Address

City

State

Zip Code

Number of Dependents

E-mail Address (Required)

Please list one personal reference (can be a family member) who does not live with you.

Name

Relationship

Phone No.

Address

City

State	Zip Code

Do you have a Savings Account?

If yes, where?

Savings Account Number

Do you have a Checking Account?

If yes, where?

Checking Account Number

Are you a U.S. Citizen or permanent alien?

Is your income likely to decline in the next two years?

Are you a co-maker, co-signer or guarantor on any loan not listed above?

If yes, list the name of others obligated on loan and the name of the creditor.

Are you responsible for alimony or child support?

Employer Information (Co-Applicant)

Employer Name

Position

Hire Date

Employer Address

Work Phone w/Area Code

City

State

Zip Code

Monthly Gross Wages

Other Income & Source

Supervisor's Name

Previous Employer

How long at previous employer?

Position

Balance Transfer Request
Yes, I would like to transfer balances from my other credit cards to my BSE VISA Card.

Creditor

Account Number

Current Balance

Amount to Transfer

Creditor

Account Number

Current Balance

Amount to Transfer

Creditor

Account Number

Current Balance

Amount to Transfer

You are hereby authorized to pay off the amount shown on the above charge account(s) by issuing the check(s) as indicated and adding the balance to my BSE Credit Union card account (may not exceed BSE Credit Union Limit). Note: the credit union recommends you pay any minimum payments which are due within the next 15 days to avoid late charges caused by processing and mailing time requirements. This plan is treated the same as a purchase according to the terms set forth in the disclosure.

By clicking here, I agree to the terms above.

I hereby authorize the Credit Union to whom this application is made, or any Credit Bureau or other investigative agency employed by such Credit Union, to investigate the references herein listed or statements or other data obtained from me or from any other source whatsoever pertaining to my credit and financial responsibility. The Ohio laws against discrimination require that all creditors make credit equally available to all credit worthy 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.