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Cintel Federal Credit Union
Visa Credit Card Application

Please provide all the requested information. When you have completed the form, press the Submit button to send your application for processing. You'll hear back from us in two to four working days.

    ***YOU MUST BE A MEMBER OF THE CINTEL FEDERAL CREDIT UNION IN ORDER TO APPLY*** 


Type of Visa requested 

New Limit requested 
Primary Applicant

Member Number 
Last Name  First Name 
Social Security #       Date of Birth 
Address 
City     State 
Home Phone    ZIP code 
E-Mail Address 

Employer Name 
Employer Phone Number 
Job Start Date   Month/Year
Gross Income   Hourly  Monthly Annually
    
   Debts                     Monthly Payment

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Joint Applicant (if applicable)

Member Number 
Last Name  First Name 
Social Security #       Date of Birth 
Address 
City     State 
Home Phone    ZIP code 
Employer Name 
Employer Phone Number 
Job Start Date   Month/Year
Gross Income    Hourly  Monthly Annuall
    
   Debts                     Monthly Payment

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Please note: Income verification is required; other information may be required.

This statement is submitted to obtain credit, and I certify that all information is true and complete. I authorize Cintel Federal Credit Union to verify the information contained in this statement and to obtain further information concerning my credit standing. I agree that by using, or permitting others to use my credit card account, I will have agreed to be bound by all of the terms of the Cardholder Agreement which will be delivered to me with my card, including the provision which grants to Cintel Federal Credit Union a security interest in my share savings accounts and or deposits with Cintel Federal Credit Union. Therefore, if you are in default on a financial obligation to us, we reserve the right to apply the balances of shares and dividends in all individual and joint accounts you have with us to satisfy the obligation. I also certify that I am at least 18 years of age.

Notice: 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.

Alimony, child support, or separate, maintenance income need not be listed unless you choose to have such income considered regarding extension and repayment of the credit requested.


I certify that statements on this application are true and complete. I authorize any person, association, firm or corporation to furnish, on request of this Credit Union, information concerning me or my affairs.(Sec. 1014, Title 13, U.S. Code makes it a Federal Crime to knowingly make a false statement on this application of a Federal Credit Union.)