"Giving
individual attention while making your dreams come true"
Credit Card Application -
Sheboygan County residents only. If you live outside of
the area. Please contact us.
Please provide all the requested
information. When you have completed the form, press the
Submit button to send your application or print it and
mail it to us. You'll hear back
from us as soon as possible, usually within one business
day. All our forms are encrypted for your
security
Card
Information * =
Required Fields
Card Type
Limit requested
*
Are you an
existing Oostburg
State Bank customer?
If yes, what is your
Account Number
Credit
Type
You may apply for individual
or joint credit, but choose only one of
the following. Thank you.
Notice to
married applicant: No
provision of a marital property
agreement, a unilateral statement under
Wis. Stat. sec 766.59 or a court decree
under Wis Stat. sec 766.70 adversely
affects the interests of the credit
union unless prior to the time the
credit is extended, the credit union is
furnished with a copy of the agreement
statement or decree, or has actual
knowledge of the adverse provision when
the obligation to the credit union is
incurred.
Personal Information
First Name:
*
Middle Initial:
Last Name:
*
Social Security Number:
*
Marital
Status:
(Unmarried includes
single, widowed and divorced)
Birthdate
*
(xx/xx/xxxx)
Home Street Address:
*
City:
*
State:
Zip:
How Long?
Employment
Information
Work Phone Number:
Employer name:
*
Position:
Gross Income per
Month:
*
How Long
Employed:
Source
of other income
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.
Amount per
month:
Joint or
Other Applicant Information
If your loan
application is for joint credit,
for individual credit relying on
income or assets from other
sources, or you are married and
reside in a community
property state, you must also
fill out this section of the
application. If
you are applying for individual
credit, you can skip this
section.
Name:
Social Security
Number:
Marital
Status:
(Unmarried includes
single, widowed and divorced)
Birth date
(xx/xx/xxxx)
Home Street Address:
City:
State:
Zip:
How Long?
Home Phone
Number:
Employment
Information
Work Phone
Number:
Employer name:
Position:
Gross Income per
Month:
How Long
Employed:
Source
of other income
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.
Amount per
month:
Asset Information
Savings/Checking
balance
Real Estate- locations,
value
Auto - year, make model
Other Asset
Other Asset
Debt Information
List all debts and
credit accounts, replacing
"Other" with description. If
those listed do not apply, please say
"None" for balance &
payment..
Balance
Monthly Payment
Rent or Mortgage
Credit Card
Auto Payments
Automatic
Payment Method
You do not have to
select an automatic payment method to
obtain credit. These are offered to you
as a service from our institution.
We will contact you with full details on
this method of payment if you select it
as an option.
Automatic Loan Payment
(Payment is transferred monthly on the
due date.)
From
Savings
From
Checking
Any
comments or questions you may have for
us? Please indicate preferred method and
time to contact you
Email Address:
By submitting this
application, I/We certify that this
information has been supplied
truthfully, accurately and voluntarily,
and therefore authorize Oostburg State
Bank. to investigate our
creditworthiness, credit history and
financial responsibility through any
credit bureau or by any other reasonable
means for consideration for the loan
applied for, or for any other services
offered. This application does not
constitute a contract for the extension
of credit.
Thank You. Upon
receipt of this application, someone at
Oostburg State Bank will review
your information and get back to you to
extend credit, with additional questions
or to request further information.
We appreciate this opportunity to be
your financial partner.
CREDIT TERMS
The following information is a general summary of plan options and is accurate as of
:
The information is
subject to change. You may obtain
current information by writing to us at
Oostburg State Bank, PO Box 700198,
Oostburg, WI 53070
Annual Percentage
Rate for Purchases
Other APR’s
Variable
Rate Information
Grace Period
Method for
Computing the Balance for
Purchases
Annual
Fee
9.25%
VISA Classic Card
12.75%
VISA Gold Card
Balance
Transfer APR: 9.25% or 12.75%
Cash
Advance APR: 9.25% or 12.75%
The
annual percentage rate may vary.
The rate is determined by the
highest prime rate published in
The Money & Investing Section
of The Wall Street Journal of the
prior month (“Index) plus 4
percentage points for a VISA
Classic Card and 7.5 percentage
points for a VISA Gold Card.
25
Days
Average
Daily Balance Including New
Purchases
None
Late Fee: $25.00, Overlimit Fee: $25.00,
Cash Advance Transaction Fee: 2.5% per
Cash Advance Transaction with a minimum
fee of $2.00 and maximum fee of $5.00.
FOR MARRIED WISCONSIN APPLICANTS ONLY
I certify that the credit being applied for, if granted, will
be incurred in the interest of my
marriage or family.
REMINDER: This
application is for residents of Sheboygan
County. If you live outside of this area
please contact us.
