AmaZing Rewards

AmaZing Rewards^® Credit Card

Earn Rewards On Everyday Purchases

A unique rewards card loaded with additional features and benefits from the bank you know and trust.

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Acceptance Code*

First Name*

Last Name*

Last 4 of SSN*

Address*

City*

State*

Zip Code*

Email*

Authorized User

The Authorized User indicated below will be issued a credit card in the name specified. This User has access to the entire credit limit and will not be responsible for payment of the credit card balance.

First Name

Last Name*

Date of Birth

Obligated Party (Primary Borrower) I fully understand and agree that all Authorized Users of my Visa Credit Card are my responsibility and that the Authorized Users are not obligated to the repayment of the credit card balance. If the credit card is misused by an Authorized User, I accept full responsibility. Also, if the card(s) are lost or stolen, I will immediately notify Bankcard Services at 888-758-5349.

I have read and understand the Consumer Credit Card Agreement and Disclosure Statement

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AmaZing Rewards® Credit Card

Earn Rewards On Everyday Purchases

Disclosures

AmaZing Rewards^® Credit Card