Shared Secured Credit Card Application

Shared Secured Credit Card Application
- A Share Secured Visa Card is a Visa Card that is secured using matching funds in your savings account as collateral.
- For this application to be processed, the balance in your savings account must be equal to or greater than the requested limit.
- This application is for a Share Secured Visa Card with an interest rate of 16.90% or a Rewards Share Secured Visa Card with an interest rate of 19.90%.
Account Information
Name: *

First NameLast Name
It'sMyCU Account Number *
Last Four Digits of your SSN *
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address: *
example@example.com
Phone Number: *
Credit Card Request Information
Which Share Secured Visa Card are you applying for?

Rewards Share Secured Visa CardPlatinum Share Secured Visa Card
VISA Limit:*
MUST have the same amount of funds available in a share account with ISCU.
ItsMyCU Debt Protection includes life, disability, and involuntary unemployment coverage.
- In the event you pass away,your credit card balance will be paid in full.
- In the event you become disabled or lose your job involuntarily, monthly payments could be paid towards your balance.
Do you want to add debt protection to your credit card?*

YesNo
Account Number with matching funds: *
This is the account or share the funds will be on hold in
Are you on this account?*

YesNo
Last four digits of Account Holder's SSN*
What is the name of the account holder?*
This individual will also need to sign an additional form authorizing the hold to be placed on the funds
Applicant Signature*

Clear
Signature of Account Holder with Matching Funds authorizing ItsMyCU to hold funds for applicant's VISA*

Clear
Date

MonthDayYear
Date
Should be Empty:

Shared Secured Credit Card Application

Account Information

Credit Card Request Information