Credit Card Application
Please print this form and mail it to:
     American Savings, FSB
     8230 Hohman Ave.
     Munster, IN  46321
or bring it into the branch office of your choice.
 

Card  Information
Card Type 
VISA Classic Card
Master Card
Limit requested
Are you an existing American Savings, FSB customer?  Yes  No
If yes, what is your Account Number
Credit Type  (for joint property states only)
You may apply for individual or joint credit, but choose only one of the following.  Thank you.

Individual Credit - unmarried applicant
  Individual Credit - married applicant
  Joint Credit - with your spouse
  Joint Credit - with an applicant or cosigner who is not your spouse

Personal Information
First Name:
Middle Initial:
Last Name:
Social Security Number:
Marital Status: Married
Unmarried
(includes single, widowed and divorced)
Birthdate (xx/xx/xxxx)
Home Address:
   City:
   State:
   Zip:
How Long?
If you've lived at your current address less than 2 years, please provide your previous home address:
Previous Home Address:
   City:
   State:
   Zip:
Home Phone Number:

Employment Information
Work Phone Number:
Employer name:
    Address:
    City:
    State:
    Zip:
Position:

Joint or Other Applicant Information

If your loan application is for joint credit, for individual credit relying on income or assets from other sources, or you are married and reside in a  community property state, you must also fill out this section of the application. If you are applying for individual credit, you can skip this section.
Name:
Social Security Number:
Marital Status: Married
Unmarried
(includes single, widowed and divorced)
Birth date (xx/xx/xxxx)
Home Address:
   City:
   State:
   Zip:
How Long?
Home Phone Number:
If you've lived at your current address less than 3 years, please provide your previous home address:
Previous Home Address:
   City:
   State:
   Zip:

Employment Information
Work Phone Number:
Employer name:
    Address:
    City:
    State:
    Zip:
Position:
Salary per Month:
How Long Employed:
Source of other income
Note: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Amount per month:

Income & Asset Information
Gross monthly income:
Other income Note: Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
Savings/Checking balance
Real Estate- locations, value
Auto - year, make model
Other Asset
Other Asset

Debt Information 

List all debts and credit accounts, replacing "Other" with description. If those listed do not apply, please say "None" for  balance & payment..
 

Balance

Monthly Payment
Rent or Mortgage
Credit Card
Auto Payments

Insurance and Payment Options
Credit Life and Credit Disability Insurance
This insurance is available to help protect you in the future. Credit life and credit disability insurance are not required to obtain credit. (insert fees and a link to insurance information here....)

I request the following Insurance Coverage:

Automatic Loan Payment Method

You do not have to select an automatic payment method to obtain credit. These are offered to you as a service from our institution.  We will contact you with full details on this method of payment if you select it as an option.  (If your institution offers lower rates for this payment method,  note that here)

Automatic Loan Payment (Payment is transferred monthly on the due date.)
From Savings
From Checking

 
Any comments or questions you may have for us?

Email Address: 

By submitting this application, I/We certify that this information has been supplied truthfully, accurately and voluntarily, and therefore authorize American Savings, FSB. to investigate our creditworthiness, credit history and financial responsibility through any credit bureau or by any other reasonable means for consideration for the loan applied for, or for any other services offered.  This application does not constitute a contract for the extension of credit.  

Thank You.  Upon receipt of this application, someone at American Savings, FSB will review your information and get back to you to extend credit, with additional questions or to request  further information. We appreciate this opportunity to be your financial partner.