EFTA00186420¶
Account Application: Platinum MasterCard or Visa Platinum Credit Card¶
A ACCOUNT INFORMATION¶
YOU WISH TO OPEN THE FOLLOWING ACCOUNT:¶
- Platinum MasterCard (MR2/PLAT)
- Visa Platinum Card (MR3/PLAT)
YES, Please sign up for Chase Travel Rewards¶
A ACCOUNT INFORMATION¶
| Accountholder Name | Date of Birth | Social Security Number |
|---|---|---|
| Mailing Address | 301 East 66th Street, Apt 10N | City New York |
| Length of Time at Current Address | 01/01/04 | Rent |
| Number of Dependents (including yourself) | Mother’s Midden Name (Required for Security purposes) | |
| Previous Home Address (If current address less than three years) | City State | |
| Years There | 10 | |
| Name of Business | Business Telephone Number | Yeast There |
| Business Address | City State | Zip Code |
| Status | Self Employed Retired |
B ADDITIONAL CARDS FOR AUTHORIZED USERS¶
PLEASE ENTER CARDS FOR THE PERSONS LISTED BELOW (FIRST, MIDDLE, LAST):¶
- FED 24 2004
- PRIORITY SERVICES
C FINANCIAL INFORMATION¶
PLEASE COMPLETE THIS SECTION WITH TOTALS FOR ALL APPLICANTS OR ATTACH A CURRENT FINANCIAL STATEMENT:¶
- ANNUAL INCOME
- Account Holder
All attorneys, valid impost, or requires maintenance must not be revoked for noncompliance as a basis of repaying a loan extended under a law of credit.¶
D AUTOMATIC PAYMENT¶
PLEASE SELECT ONE IF YOU REQUEST AUTOMATIC BILL PAYMENT FROM YOUR ACCOUNT:¶
- Minimum Payment. The minimum balance due will be paid on your card automatically each month.
- Full Payment. The full balance due on your credit card will be paid automatically each month.
PLEASE BRIT THE FOLLOWING ACCOUNT FOR PAYMENT ON THE BALANCE:¶
- Bank Name: J.P. Morgan Chase
- Account #:
E SIGNATURE¶
I HAVE READ AND AGREE TO THE NOTICE AND ADDITIONAL DISCLOSURES ON THE REVENUE¶
- Signature (Primary Account Holder) Date:
INTERNAL USE ONLY¶
- CA Plag 6 Location Code 211211 Credit Line AUM
- Number Client Service Terms CST #
- ACT # ACT 4
See here 2 for Disclosures regarding rates, fees, and additional costs and other information for this offer.¶
21500¶
EFTA00186421¶
| 2 TO 97584078 | P.08/09 |¶
| :--- | :--- |¶
Account Application: Platinum MasterCard or Visa Platinum Credit Card¶
A ACCOUNT INFORMATION¶
YOU WISH TO OPEN THE POLLOWING ACCOUNT:¶
- Platinum MasterCard (MR2/MPLAT)
- Visa Platinum Card (MR3/VPLAT)
Yes, please sign up for Chase Travel Rewards.¶
| Accountholder Name | Date of Birth | Social Security Number |
|---|---|---|
| Mailing Address | City | New York |
| Telephone Number | Length of Time at Current Address | Rent |
| Previous Home Address (if at current address less than three years) | City | State |
| Years There | 10 | |
| Name of Business | Business Telephone Number | Years There |
| Business Address | City | State |
B ADDITIONAL CARDS FOR AUTHORIZED USERS¶
PLEASE ISSUE CARDS FOR THE PURCHASES LASTED BELOW (FIRST, MIDDLE, LAST).¶
FED-2-4-2004¶
C FINANCIAL INFORMATION¶
PLEASE COMPLETE THIS SECTION WITH TOTALS FOR ALL APPLICANTS OR ATTACH A CURRENT FINANCIAL STATEMENT:¶
- ANNUAL INCOME*
- Accountholder $
All payments, child support, or separate maintenance need not be rewritten for consideration as a basis of repaying a loan extended under a line of credit¶
D AUTOMATIC PAYMENT¶
PLEASE SELECT ONE IF YOU REQUEST AUTOMATIC BILL PAYMENT FROM YOUR ACCOUNT:¶
- Minimum Payment. The minimum balance due will be paid on your card automatically each month.
- Full Payment. The full balance due on your credit card will be paid automatically each month.
PLEASE DEBIT THE FOLLOWING ACCOUNT FOR PAYMENT ON THE BALANCE:¶
Bank Name | Bank Number | Account #¶
E SIGNATURE¶
I HAVE READ AND AGREE TO THE NOTICE AND ADDITIONAL DISCLOSURES ON THE REVERSE¶
SIGNATURE (Primary Accountholder) | Date |¶
INTERNAL USE ONLY¶
CIA Flag | 6 Location Code | Credit Line | AUM | Basket | Client Service Team | 657# | ACT Date | ACT # |¶
See page 2 for Disclosures regarding fees, fees and additional costs and other information for this offer.¶
2,500 Susan¶