Accepted worldwide, a CAP COM VISA® Credit Card is the only card you’ll ever need. You’ll enjoy low fixed rates, flexible spending limits and no annual fee.

Applying is easy! Complete the attached application and drop it at any CAP COM branch or mail to: CAP COM Federal Credit Union 4 Winners Circle Albany, NY 12205

You can also apply online at www.capcomfcu.org/creditcard or call us at (518) 458-2195.

VISA Classic

13.90%APR* fixed• Spending limits $500 - $15,000. • No annual fee. • Save with our VISA Discount Program and Member Discounts. • Automatic accidental death and dismemberment coverage up to $200,000.1 • Zero Liability Protection on unauthorized purchases. • Auto rental coverage due to collision or theft.2

VISA Platinum

9.90%APR* fixed• Spending limits $1,000 - $30,000 • No annual fee • Rewards Program, including choice of: • Cash Back • Airline Tickets • Merchandise or Gift Cards • Save with our VISA discount program and Member Discounts. • Automatic accidental death and dismemberment coverage up to $1 million.1 • Zero Liability Protection on unauthorized purchases. • Auto rental coverage due to collision or theft.2 • Travel and emergency assistance services.3 • Extended warranty protection.4

*Annual Percentage Rate 1 Valid during travel only on travel expenses when you charge your entire travel fare via common carrier to your CAP COM VISA Credit Card. 2 Reimbursement up to the actual cash value of the rental for card holders that use the VISA to initiate and complete the entire rental transaction. 3 Offers the cardholder, spouse and children, at no cost, a referral to emergency message services, medical referral assistance, legal referral assistance, emergency transportation assistance, emergency ticket replacement, lost luggage locator service, emergency translation service, prescription assistance and valuable document delivery arrangements, as well as, pre-trip assistance. This service in no way covers the expense of the assistance but merely provides the referral to a qualified vendor. 4 Warranty Manager Service offers the cardholder warranty registration and extended warranty protection that provides an additional year to a valid original manufacturer’s written U.S. repair warranty of three years or less, when the entire purchase is made with the eligible VISA. A

pplic

ant’s

Info

rmat

ion

We

cann

ot p

roce

ss y

our a

pplic

atio

n un

less

all

the

info

rmat

ion

is co

mpl

ete.

C

AP

CO

M F

CU

VIS

A® C

red

it C

ard

Ap

plic

atio

n

Nam

e

(Las

t)(F

irst)

(Mid

dle

Initi

al)

Socia

l Sec

urity

Num

ber

--

Birth

Dat

e (m

m/d

d/yy

)

//

Hom

e Te

leph

one

)-

(Ce

ll Te

leph

one )

-(

Hom

e Ad

dres

s

City

Ti

me

at C

urre

nt A

ddre

ss

Mon

thly

Hous

ing

Paym

ent

$ Empl

oyer

Fu

ll Ti

me

P

art T

ime

S

elf E

mpl

oyed

Ret

ired

Stud

ent

Date

of H

ire/ R

etire

men

t (m

m/y

r)

/Bu

sines

s Tel

epho

ne )-

(

E-m

ail A

ddre

ss

U.S.

Per

son?

Yes

No

Resid

ence

O

wn

Rent

Li

ving

With

Oth

ers

Oth

er

Addr

ess

2

Gro

ss M

onth

ly In

com

e O

ther

Mon

thly

Inco

me

Rece

ived

In A

pplic

ant’s

Nam

eSo

urce

Of O

ther

Mon

thly

Inco

me

Stat

e Zi

p

Cred

it Li

mit

Requ

este

d

Nam

e

(Las

t)(F

irst)

Hom

e Te

leph

one

)-

(Ce

ll Ph

one

)-

(

Year

sM

onth

s

$,

$,

$,

Not

ice: A

limon

y, ch

ild s

uppo

rt or

sep

arat

e m

aint

enan

ce in

com

e ne

ed n

ot b

e re

veal

ed if

you

do

not w

ish to

hav

e it

cons

ider

ed.

Empl

oym

ent I

nfor

mat

ion

Ref

eren

ce

BALA

NCE

TRA

NSF

ER F

ROM

OTH

ER IN

STIT

UTIO

NS

(CAN

NOT

TRA

NSF

ER C

CFCU

LO

ANS)

If

addi

tiona

l cre

dito

rs, u

se s

epar

ate

shee

t for

info

rmat

ion.

Prin

t you

r bal

ance

s in

the

orde

r you

wan

t the

m p

aid.

We

will

tran

sfer

as

muc

h as

pos

sible

with

out e

xcee

ding

you

r cre

dit l

imit.

Unt

il yo

ur b

alan

ce tr

ansf

ers

are

proc

esse

d, w

hich

may

take

2-4

w

eeks

, you

may

nee

d to

mak

e a

paym

ent o

n yo

ur o

ther

cre

dit c

ards

to k

eep

them

cur

rent

. Bal

ance

tran

sfer

s to

oth

er in

stitu

tions

are

cas

h ad

vanc

e an

d do

not

hav

e a

grac

e pe

riod.

Tran

sfer

s

Cred

itor N

ame:

A

ddre

ss:

Acco

unt #

:

A

mou

nt to

tran

sfer

(Spe

cific

$ am

ount

. not

“al

l”:

Cred

itor N

ame:

A

ddre

ss:

Acco

unt #

:

A

mou

nt to

tran

sfer

(Spe

cific

$ am

ount

. not

“al

l”:

Cred

itor N

ame:

A

ddre

ss:

Acco

unt #

:

A

mou

nt to

tran

sfer

(Spe

cific

$ am

ount

. not

“al

l”:

Cred

itor N

ame:

A

ddre

ss:

Acco

unt #

:

A

mou

nt to

tran

sfer

(Spe

cific

$ am

ount

. not

“al

l”:

cont

inue

s on

sec

ond

side

,

Phone Numbers & WebsiteCCFCU Phone (518) 458-2195CCFCU Toll Free (800) 468-5500CCFCU Fax (518) 458-2261Touch-24 (518) 458-8986Touch-24 Toll Free (800) 634-2340Connect-24 & Mobile Banking www.capcomfcu.org

Financial Center & Mailing Address4 Winners Circle • Albany, NY 12205

Albany • Brunswick • Clifton Park Cohoes • Colonie • Glenmont

Latham • Niskayuna • North Greenbush

How We Will Calculate Your Balance: We use a method called “average daily balance” (including new purchases). Contact For Updates: The information about the cost of the card described in this application is accurate as of March, 2013. This information may have changed after that date. To find out what may have changed, call us at (800) 449-7728 or write us at P.O Box 3112, Tampa, FL 33631-3112, Attn: Customer Service.Not all products receive Convenience Checks. Not all products offer Overdraft Protection. Notice to New York Residents: You may contact the New York State Banking Department at 1-866-951-3873 or by writing to the Research & Technical Assistance Division, 1 State St. NY, NY 10004-1417 to obtain a comparative listing of all credit card rates, fees and interest-free periods. Notice to Married Wisconsin Residents: No provision of any marital property agreement, unilateral statement under section 766.59, adversely affects our interest unless we, prior to the time the credit is granted or an open-end credit plan is entered into, are furnished a copy of the agreement, decree or court order, or have actual knowledge of the adverse provisions. IF YOU ARE A MARRIED WISCONSIN RESIDENT, CREDIT EXTENDED UNDER THIS ACCOUNT WILL BE INCURRED IN THE INTEREST OF YOUR MARRIAGE OR FAMILY.

Important Terms and Application AgreementBy signing below, you understand and agree that CAP COM Federal Credit Union (“we”, “us” or “our”) as the creditor and issuer of your Account, will rely on the information provided here in making this credit decision, and you certify that such information is ac-curate and complete to the best of your knowledge. If we open an Account based on this Application, you will be individually liable (or, for joint Accounts, individually and jointly li-able) for all authorized charges and for all fees referred to in the most recent Cardmember Agreement, which may be amended from time to time. We may request consumer credit reports about you for evaluating this Application and in the future for reviewing Account credit limits, for Account renewal, for servicing and collection purposes, and for other legitimate purpose associated with your Account. Upon your request, we will inform you if a consumer report was requested and, if it was, provide you with the name and address of the consumer reporting agency that furnishes the report. By providing a telephone number for a cellular phone or other wireless device, you expressly consent to receiving communications at the number, including, but not limited to, prerecorded or artificial voice message calls, text messages, and calls made by an automatic telephone dialing system from us or our affiliates. This express consent applies to each such telephone number that you provide to us now or in the future and permits such calls regardless of their purpose. These calls and messages incur access fees from your cellular provider. By signing the application, you also agree that we may verify your employment, income, address, and all other information provided with other creditors, credit reporting agencies, employers, third parties, and through records maintained by federal and state agencies (including state motor vehicle departments) and waive any rights of confidentiality you may have in that information under applicable law. You also agree that should your Application for a VisA Platinum card be denied, submitting this Application constitutes your permission to automatically consider you for a VisA Classic card. Information from this application may be shared with our affiliates. By signing below, you certify that you read and understood the disclosure here and you agree to the terms of this Application.

Notice to California Residents: An applicant, if married, may apply for a separate Account. Notice to Ohio Residents: The Ohio law 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 the law. Reward Program Rules: We will award one point for each dollar of “net purchases” (purchases minus returns/credits) charged to a CU Rewards Platinum Card Account during each statement period. There is no limit to the number of points one can earn with a CU Rewards Platinum Card. Points will not be awarded to a cardmember for “net purchases” during a statement period if the cardmember’s Account is not open and current on the statement closing date. Points will not be awarded for Cash Advances or other Account Advance as defined in the Cardmember Agreement. Points will be awarded to the primary cardmember and may be redeemed by an authorized cardmember on the Account. CU Rewards Platinum cardmembers can redeem points for round-trip airfare beginning at 25,000 points in addition to Gift Certificates, Name Brand Merchandise Rewards and more. Complete terms and conditions for the Rewards program will be provided to CU Rewards Platinum cardmembers. Service provided by Montrose Travel. The creditor, issuer and service provider is CAP COM Federal Credit Union.

Applicants signatureX mm / dd / yy

You promise that everything you have stated in this request for credit is correct to the best of your knowledge. If there are any important changes, you will notify us in writing immediately. You authorize the Credit Union to obtain credit reports in connection with this request for credit and for any update, increase, renewal, extension, or collection of the credit received. You understand that the Credit Union will rely on the information provided and your credit report to make its decision. If you request, the Credit Union will tell you the name and address of any credit bureau from which it received a credit report on you. It is a federal crime to willfully and deliberately provide incomplete or incorrect information on loan requests made to federal credit unions or state chartered credit unions insured by NCUA.

VISA® CRedIt CARdS

www.capcomfcu.org

Summary Of VISA Account termsInterest Rates and Interest Changes Annual Percentage Rate (APR) for Purchases VISA Classic 13.90% Visa Platinum 9.90%

APR for Cash Advances APR for Balance transfersHow to Avoid Paying Interest on PurchasesMinimum Interest Charge

Your due date is at least 25 days after the close of each billing cycle. We do not charge you interest on purchases if you pay your entire balance by the due date each month.None

VISA Classic 13.90% Visa Platinum 9.90% VISA Classic 13.90% Visa Platinum 9.90%

To learn more about factors to consider when applying for or using a credit card, visit the website of the Consumer Financial Protection Bureau at http://www.consumerfinance.gov/learnmore.

For Credit Card tips from the Federal Reserve BoardFees Annual Feestransaction Fees - Foreign TransactionPenalty Fees- Late Payment Fee- Returned Payment Fee

None

1.00% of each transaction in U.S. dollars.

$25.00 or the amount of the required minimum payment, whichever is less, if you are more than 10 days late in making a payment. Check returned unpaid = $10 or the amount of the required payment, whichever is less.Electronic Payment (ACH) returned unpaid = $ 30 or the amount of the required payment, whichever is less.

Other Fees Statement Copy FeeRush Fee

$2.00 $25.00

Card Replacement Fee $5.00 per card

Federally insured by NCUA. VCC-09/2014