HSB COMMERCIAL CREDIT CARD APPLICATION_0308 by ypy11747

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									                                                                                                     COMMERCIAL CREDIT CARD APPLICATION
COMPANY INFORMATION                                           *Please provide 2 years of business financial statements and interim comparative financials
Name of Company

Organized as:      Corporation                     Sole Proprietor            Partnership        LLC       Non-Profit                 Other:
Requested Total Company Limit $                                                              Annual Sales $

Name of Billing Contact                                                                      Email Address

Company Name to appear on card(s) if different from above. Max 24 characters.

Physical Address (No PO Boxes)                                                               City                                                          State       Zip

Billing Address (if different than street address)

Billing Address (cont.)                                                                      City                                                          State       Zip

Company Phone                                                                                Month/Year Established

Business /Tax ID Number                                                                      Nature of Business

Automatic Payment from Bank Account                  Yes     No    Do you have other accounts with Home Savings Bank?
Routing #                  Account #                                                        Yes      No
Automatic Payment Method:        Minimum Payment Due             New Balance
Statement Option:     Individual bill (separate for each card)  or    Corporate bill (on statement for two or more cards)
APPLICATION INFORMATION                                                                                      whose                       below.
                                                  (Must be signed by Owner/Authorized Officer of the Company w hose information is shown below. )
Name: First, MI, Last                                                                        Email Address

Street Address                                                                               City                                                          State       Zip

Social Security Number                                                                       Date of Birth

Home Phone
                                                                                             Residential Status            Own           Rent
                                                                                                                                        How long at address Years/Months
Business Ownership:              Owner           President          Principal Partner           Other:
PRIMARY IDENTIFICATION FORM (Permanent Driver’s License-state of issuance, State Non-Driver’s ID Card, County ID Card-county of issuance,
Resident/Alien Card or Armed Forces ID branch of Service)
ID Type                           ID#                                                        Date of Issuance                           Expiration Date

SECURITY CODE: Your Home Savings Bank Security Code is a unique, personal code created by you (i.e. name of favorite pet, high school mascot, name of elementary school
attended, etc.) This security code will be used as an additional manse of personal identification when contacting Home Savings Bank. If you have an existing code, but do not
remember it, or wish to change it, please provide a new code. Your customer record will be updated. Security Code:


CARDHOLDER INFORMATION                                          (Please
                                                                (P lease provide the names (including applicant) of the individuals to be issued cards.
                                                                                     If more than 5 please continue on page 3)
1. Name: First, MI, Last (Primary Cardholder)                                               Credit Limit           Signature

2. Name: First, MI, Last                                                                    Credit Limit           Signature

3. Name: First, MI, Last                                                                    Credit Limit           Signature

4. Name: First, MI, Last                                                                    Credit Limit           Signature


IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding to terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify and record information that
identifies each person who opens an account. What this means for you: When you open an account, we will ask your name address, date of birth, and other information that
will allow us to identify you. We may ask to see your driver’s license or other identifying documents.
AGREEMENT
By signing below I certify that the information in and accompanying this application is true and complete. Applicant and I authorize Home Savings Bank or
it’s agents to verity this information and obtain additional information about Applicant or me from credit bureaus or any other sources and to report to
others such information and credit experiences with Applicant or me. Acceptance or use of any card issued will be subject to the terms of the cardholder
agreement that will be sent with a card, and Applicant will be responsible for all obligations incurred according to those terms.


Signature                                                                                                           Title                                                                        Date


Print Name
For individual or sole proprietor who reside in community property states such as Wisconsin check one:
     Married – If you checked married, the name and social security number of your spouse is:
     Unmarried                                                                                                                                                      Print Name
     Separated
                                                                                                                                                                      SS#
PERSONAL GUARANTY                                                                                                                                                           *Personal Financial S tatement required.
To induce Home Savings Bank to extend credit to the business/applicant named in this application (“Applicant”), each of the undersigned, jointly and
severally, unconditionally guarantee payment to Home Savings Bank of the Obligations of Applicant when due. “Obligations” means all loans, advances,
fees, charges, interest; finance charges and all other debts, obligations and liabilities of every kind and description, arising out of all Home Savings Bank
VISA credit cards now and hereafter issued to Applicant and the cardholder agreements now or hereafter in effect for those cards. Obligations include all
costs, expenses and attorneys’ fees incurred in endeavoring to collect the Obligations or realize upon this guarantee. Each of the undersigned: (i) waive
notice of acceptance of the guarantee, creation of any present or future Obligation, and default under any Obligation; (ii) waive proceedings to collect,
diligence of collection, and presentment, demand, protest, notice of protest and notice of nonpayment; (iii) waive any defense arising by reason of any
defense of the Applicant or any other guarantor: (iv) waive the right to require Home Savings Bank to proceed against Applicant or any other guarantor or
to pursue any remedy in connection with the Obligations; and (v) waive notification of any additional indebtedness or increase in credit limits or changes
in Applicant’s financial condition. Each of the undersigned authorize Home Savings Bank, without notice or consent, to extend, modify, compromise,
accelerate, renew or otherwise change, alter or amend the terms to the Obligations and to release or agree not to sue any guarantor. Each of the
undersigned authorizes Home Savings Bank to obtain credit information from time to time on any of us from any credit-reporting agency or other sources
with out further notice. This guaranty does not replace any other guarantees of the undersigned to Home Savings Bank. This is a continuing guaranty of
payment and not of collection and shall remain in full force and effect until Home Savings Bank receives written notice of revocation signed by the
undersigned. The laws of Wisconsin will govern this guaranty. EACH OF THE UNDERSIGNED WAIVES THE RIGHT TO A TRIAL BY JURY.
I agree to be bound by the Regulations received with my card, which includes a set-off agreement. Each person signing this application will be obligated
accordingly to the terms of the Regulations.



Signature                                                                                                           SS #                                                                         Date


Print Name
For individual or sole proprietor who reside in community property states, check one:
     Married – If you checked married, the name and social security number of your spouse is:
     Unmarried                                                                                                                                                     Print Name
     Separated
                                                                                                                                                                   SS#


Signature                                                                                                           SS #                                                                         Date



Print Name
For individual or sole proprietor who reside in community property states, check one:
     Married – If you checked married, the name and social security number of your spouse is:
     Unmarried                                                                                                                                                     Print Name
     Separated
Fair Credit Reporting Act Notice for Natural Persons                                                                                                              SS#
Unless you direct Home Savings Bank at 608.282.6000 to do otherwise, Home Savings Bank affiliates may share amongst themselves information that is in your credit report and this application.
Disclosure
Annual Fee                                                                                                                  $25 per card
Annual Percentage Rate                                                                                                      No Greater than Prime Rate + 3%
Grace Period*                                                                                                               25 days*
Method for Computing                                                                                                        Average Daily Balance (including New Purchases)
                                                                                                                            Late Payment fee: 5% of balance or $25, whichever is more (minimum $25)
Paying Late or Exceeding the Credit Limit
                                                                                                                            Over Limit fee: $39
Minimum Monthly Payment                                                                                                     5% of balance due
Return Check Fee                                                                                                            $25
Replacement Card Fee                                                                                                        $20
*Not applicable on cash advances.
Home Savings Bank reserves the right to request additional information from you or your company. Products and services subject to credit/bank approval.
Additional Cardholder Information
CARDHOLDER INFORMATION              Please provide the names (including applicant) of the individuals to be issued cards.
                                                                                          indivi duals
5. Name: First, MI, Last                               Credit Limit    Signature

6. Name: First, MI, Last                               Credit Limit     Signature

7. Name: First, MI, Last                               Credit Limit     Signature

8. Name: First, MI, Last                               Credit Limit     Signature

9. Name: First, MI, Last                               Credit Limit     Signature

10. Name: First, MI, Last                              Credit Limit     Signature

11. Name: First, MI, Last                              Credit Limit     Signature

12. Name: First, MI, Last                              Credit Limit     Signature

13. Name: First, MI, Last                              Credit Limit     Signature

14. Name: First, MI, Last                              Credit Limit     Signature

15. Name: First, MI, Last                              Credit Limit     Signature

16. Name: First, MI, Last                              Credit Limit     Signature

17. Name: First, MI, Last                              Credit Limit     Signature

18. Name: First, MI, Last                              Credit Limit     Signature

19. Name: First, MI, Last                              Credit Limit     Signature

20. Name: First, MI, Last                              Credit Limit     Signature

21. Name: First, MI, Last                              Credit Limit     Signature

22. Name: First, MI, Last                              Credit Limit     Signature

23. Name: First, MI, Last                              Credit Limit     Signature

24. Name: First, MI, Last                              Credit Limit     Signature

25. Name: First, MI, Last                              Credit Limit     Signature

26. Name: First, MI, Last                              Credit Limit     Signature

27. Name: First, MI, Last                              Credit Limit     Signature

28. Name: First, MI, Last                              Credit Limit     Signature

29. Name: First, MI, Last                              Credit Limit     Signature

30. Name: First, MI, Last                              Credit Limit     Signature

31. Name: First, MI, Last                              Credit Limit     Signature

32. Name: First, MI, Last                              Credit Limit     Signature

33. Name: First, MI, Last                              Credit Limit     Signature

								
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