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We Offer FREE Financing!
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90 Days Same as Cash! 6 month, 9 month, 12 month ZERO INTEREST options! Hold on to your money longer with this FREE payment plan!
You can APPLY ONLINE! Click on the link below to fill out an application NOW!
Here is a SAMPLE APPLICATION, fill out the information and come in today!
APPLICATION AND INITIAL CARDHOLDER DISCLOSURE
A credit service of GE Money Bank
183-859-00
Rev. 6/08/09
DATE OF PRINTING 6/09
For WI residents, if you are applying for individual credit or joint credit with someone who is not
your spouse, combine your and your spouse's financial information on the application form.
3. APPLICANT and CO-APPLICANT: We need your signature(s) below
PLEASE READ AND KEEP THE GE MONEY BANK KEY CREDIT TERMS
AND INITIAL CARDHOLDER DISCLOSURE STATEMENT BEFORE SIGNING THIS APPLICATION.
I am providing the information in this application to GE Money Bank (“GEMB”), to GE Money credit card, to dealers (“Dealers”) that accept the GE Money credit card (“Card”) and to program
sponsors, and asking GEMB to issue me a Card. By applying for this account, I authorize and agree that:
• GEMB may furnish this and other information about me (even if my application is denied) and my account to GE Money credit card and to Dealers and program sponsors (and their
respective affiliates) to create and update their records, and to provide me with service and special offers.
• GEMB may make inquiries it considers necessary (including requesting reports from consumer reporting agencies and other sources) in evaluating my application, and for purposes of
reviewing, maintaining or collecting my account.
• If my application is approved, the GE Money credit card Agreement (“Agreement”) will be sent to me and will govern my account.
• Among other things, the Agreement: (1) INCLUDES AN ARBITRATION PROVISION THAT MAY LIMIT MY RIGHTS UNLESS I REJECT THAT PROVISION UNDER THE
AGREEMENT’S INSTRUCTIONS ; and (2) makes each applicant responsible for paying the entire amount of credit extended; and (3) grants GEMB a security interest in the goods
purchased on the account as permitted by law.
• I consent to GEMB and any other owner or servicer of my account contacting me about my account, including using any contact information or cell phone numbers I provide (whether
now or in the future) , and I consent to the use of any automatic telephone dialing system and/or an artificial or prerecorded voice when contacting me, even if I am charged for the
call under my phone plan.
• This application and the Agreement are governed by federal law and Utah law (to the extent that state law applies).
Federal law requires us to obtain, verify and record information that identifies you when you open an account. We will use your name, address, date of birth, and other
information for this purpose.
Please note that you must reside in the United States and be 18 years or older to apply.
Signature of Applicant Signature of Co-Applicant (If Applicable)
X _____________________________________________________________________________________________________ X_____________________________________________________________________________________________
(Please Do Not Print) Date (Please Do Not Print) Date
RETAILER # ACCOUNT # KEY # AMOUNT OF INITIAL
TRANSACTION
APPLICANT 1st ID TYPE/NUMBER ISSUANCE STATE EXP. DATE APPLICANT 2nd ID (CREDIT CARD TYPE & ISSUER) EXP. DATE
#___________________________________________________________________________
Driver's License State Issued Federal Government
CO-APPLICANT 1st ID TYPE/NUMBER ISSUANCE STATE EXP. DATE CO-APPLICANT 2nd ID (CREDIT CARD TYPE & ISSUER) EXP. DATE
#___________________________________________________________________________
Driver's License State Issued Federal Government
RETAILER PHONE # RETAILER FAX #
FOR RETAILER USE ONLY (Validation of Customer I. D.)
VERIFIED BY:
APPLICANT SIGNATURE MATCH APPLICANT PHOTO MATCH
YES NO YES NO
A VB - Brand Source
1. APPLICANT INFORMATION: Please tell us about yourself.
Name (First-Middle-Last) Please Print Date of Birth Social Security No. Home Phone No.
/ / - - ( )
Mailing Address* Apt.# City State Zip Time at Address Cell / Other Phone Where We May Call You
Yrs. ____ Mos. ____ ( )
*If the above address is a P.O. Box, you must provide a street address for yourself or a contact person. Your Address? Contact Person?
Contact Person Name Street Address (Street Name and Number) City State Zip
Housing Information Monthly Net Income From All Sources Time At Job Employer's Phone No. Relative Phone No.
$ __________________________ Yrs. ______ Mos. ______ ( ) - ( ) -
PARENTS/RELATIVE
OWN RENT OTHER
Alimony, child support or separate
maintenance income need not be
disclosed unless relied upon for
credit.
E-Mail Address (optional) By providing an E-mail address, I consent to receive E-mail communications about my Account and authorize you
to provide my E-mail address to the Retailer/Dealer/Merchant where I applied and the Retailer/Dealer/Merchant
where my credit card is honored so that I may receive such communications, offers and updates.
2. CO-APPLICANT INFORMATION (COMPLETE ONLY IF – CO-APPLICANT WILL RECEIVE A "GE MONEY CREDIT CARD")
Name (First-Middle-Last) Please Print Date of Birth Social Security No. Home Phone No.
/ / - - ( )
Mailing Address * Apt.# City State Zip Cell / Other Phone Where We May Call You
( )
*If the above address is a P.O. Box, you must provide a street address for yourself or a contact person. Your Address? Contact Person?
Contact Person Name Street Address (Street Name and Number) City State Zip
Housing Information Monthly Net Income From All Sources Employer's Phone No.
$ __________________________ ( ) -
Alimony, child support or separate maintenance income
PARENTS/RELATIVE need not be disclosed unless relied upon for credit.
OWN RENT OTHER
E-Mail Address (optional) By providing an E-mail address, I consent to receive E-mail communications about my Account and authorize you to
provide my E-mail address to the Retailer/Dealer/Merchant where I applied and the Retailer/Dealer/Merchant where
my credit card is honored so that I may receive such communications, offers and updates.
THE KEY CREDIT TERMS OF THE
GE MONEY
CREDIT CARD AGREEMENT ARE AS FOLLOWS:
Annual Percentage Rate (APR) for Purchases and Cash Advances
21.98% (variable)
Delinquency Rate APR * 29.99%
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We accept all major credit cards.
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