(800) 924-0022 | westconsincu.org Rev. 05.2020 | Page 1 of 6 Federally insured by NCUA

Business Credit Card Application

APPLICATION INSTRUCTIONS: Complete all fields; only fully completed applications can be processed. Documents submitted with the application will not be returned. Additional information may be needed upon request by the Loan Officer.

BUSINESS INFORMATION (APPLICANT) ☐ NEW ACCOUNT ☐ LINE INCREASE Total Credit Limit requested ___________

Business Name Primary Business Account Number Tax ID ☐ EIN ☐ SSN

Business name to appear on card (Maximum of 26 Characters including spaces)

Business Physical Address (no PO Boxes) City, State Zip

Business Mailing Address (if different) City, State Zip

Business Phone Number Email Years in Business

Legal Structure of Business

☐ Corporation (State _____) ☐ LLC ☐ Sole Proprietorship ☐ Other ☐ *Non-Profit

* If Non-Profit, include last two years financial statements and a copy of minutes showing authorization to apply.Business Gross Sales (if new, enter $0) Business Net Profit (if new, enter $0)

PRINCIPAL/AUTHORIZED PERSON(S) INFORMATION Each owner with 20% or more ownership is required to guaranty the full amount of the credit line.

Actions Authorized:

1. Borrow from WESTconsin Credit Union from time to time on behalf of this corporation such sums of money, forsuch times and upon such terms as may seem advisable to such officer(s) or person(s), including but not limitedto, the establishing of credit lines under various credit card programs offered by WESTconsin Credit Union,

2. Sign and deliver on behalf of this corporation notes or agreements therefore, and

3. Instruct WESTconsin Credit Union to issue credit cards to one or more employees or agents of the corporation.

For Electronic Services Use ONLY Add Credit Card Flag ☐

Welcome Packet ☐

(800) 924-0022 | westconsincu.org Rev. 05.2020 | Page 2 of 6 Federally insured by NCUA

OWNER OR AUTHORIZED OFFICER #1 Name (First, MI, Last) Title

Home Address (no PO Boxes) City, State Zip Percentage of Ownership

Phone Number Email Address Social Security Number

Date of Birth Personal Annual Gross Income

OWNER OR AUTHORIZED OFFICER #2 Name (First, MI, Last) Title

Home Address (no PO Boxes) City, State Zip Percentage of Ownership

Phone Number Email Address Social Security Number

Date of Birth Personal Annual Gross Income

OWNER OR AUTHORIZED OFFICER #3 Name (First, MI, Last) Title

Home Address (no PO Boxes) City, State Zip Percentage of Ownership

Phone Number Email Address Social Security Number

Date of Birth Personal Annual Gross Income

OWNER OR AUTHORIZED OFFICER #4 Name (First, MI, Last) Title

Home Address (no PO Boxes) City, State Zip Percentage of Ownership

Phone Number Email Address Social Security Number

Date of Birth Personal Annual Gross Income

(800) 924-0022 | westconsincu.org Rev. 05.2020 | Page 3 of 6 Federally insured by NCUA

CARDS TO ISSUE

Business fully understands and agrees that all Employee Cardholders listed below are the business’ responsibility if the card(s) are lost or stolen. If the credit card is misused by an Employee, business accepts full responsibility. SSN used as proof of identity only.

Cardholder’s Name (1) (How name will appear on card) Mother’s Maiden Name

Last 4 digits of SS# Date of Birth Credit Card Spending Limit

Cardholder’s Name (2) (How name will appear on card) Mother’s Maiden Name

Last 4 digits of SS# Date of Birth Credit Card Spending Limit

Cardholder’s Name (3) (How name will appear on card) Mother’s Maiden Name

Last 4 digits of SS# Date of Birth Credit Card Spending Limit

Cardholder’s Name (4) (How name will appear on card) Mother’s Maiden Name

Last 4 digits of SS# Date of Birth Credit Card Spending Limit

Cardholder’s Name (5) (How name will appear on card) Mother’s Maiden Name

Last 4 digits of SS# Date of Birth Credit Card Spending Limit

Cardholder’s Name (6) (How name will appear on card) Mother’s Maiden Name

Last 4 digits of SS# Date of Birth Credit Card Spending Limit

Cardholder’s Name (7) (How name will appear on card) Mother’s Maiden Name

Last 4 digits of SS# Date of Birth Credit Card Spending Limit

Cardholder’s Name (8) (How name will appear on card) Mother’s Maiden Name

Last 4 digits of SS# Date of Birth Credit Card Spending Limit

(800) 924-0022 | westconsincu.org Rev. 05.2020 | Page 4 of 6 Federally insured by NCUA

TOTAL CREDIT LIMIT ☐ Shared (Amount is shared between all card holders with no individual credit limits)

☐ Individual (Each card holder has a defined credit card limit – total of all individual card limits cannot exceed total credit limit)

AUTO PAYMENT OPTIONS

• By selecting the “Auto Payment Option”, I authorize WESTconsin Credit Union to initiate and continue automatic withdrawals from my designated account below.

• It will be my responsibility to make my current payment due, using another payment method. This recurring monthly payment will begin with my next statement payment due date.

• I must have sufficient funds in my account to make the designated payment (or minimum payment, whichever is greater). If there are not sufficient funds in my account, an NSF fee will be withdrawn from anther account that I am an owner of at WESTconsin Credit Union.

• If insufficient fund payments continue to occur regularly, the credit union may terminate the automatic credit card payment feature.

• I have the option to make additional payments on my own to the credit card account. Additional payments made during the cycle will be deducted from my automatic payment that is set up.

• If I wish to stop or skip any automatic payments to my credit card, I must make a written request or call WESTconsin Credit Union to terminate it prior to the due date. I can also make changes or stop the automatic payment by visiting WESTconsin Online.

WESTconsin Membership account number ________________ ☐ Savings ☐ Checking

☐ Payment in Full ☐ Minimum payment due ☐ Fixed Amount $____________

Signature Printed Name Title Date

(800) 924-0022 | westconsincu.org Rev. 05.2020 | Page 5 of 6 Federally insured by NCUA

BALANCE TRANSFERS AND CASH ADVANCES

On approval of your application, WESTconsin Credit Union can transfer the balance owed on your other credit card(s) to our WESTconsin Credit Union credit card, up to the maximum credit line approved on your WESTconsin Credit Union credit card. Please allow up to 15 business days for each payee to receive the payment being requested.

• I request and authorize WESTconsin Credit union to advance my WESTconsin Credit Union credit card line of credit.

• I understand that balance transfer advances will be treated as a cash advance, subject to terms of the WESTconsin Credit Union Credit Card Agreement listed in the disclosure, which I will receive upon acceptance into the WESTconsin Credit Union Credit Card program.

• I understand that finance charges will be applied from the day the balance(s) are transferred to my WESTconsin Credit Union credit card account. I also understand that finance charges on my other credit card account(s) accrue until the balance owed is paid in full. This payment check may not reach my other credit card company(ies) in time to pay off my balance(s) completely before my next statement closing date(s) and that I remain responsible to pay any unpaid finance charges, late payment or other charges on my other credit card(s).

☐ Please perform a balance transfer to the following:

• Account number ____________________

• Payee _______________________

• Payee Address _____________________

• Exact Amount to be paid/transferred _________________

☐ Please perform a cash advance* to the following:

• WESTconsin Credit Union Account Number ___________________

• Amount of Cash Advance _________________

* Cash Advances are only available for NEW accounts.

Signature Printed Name Title Date

(800) 924-0022 | westconsincu.org Rev. 05.2020 | Page 6 of 6 Federally insured by NCUA

OWNER/AUTHORIZED PERSON By Submitting this application, I acknowledge and agree on behalf of the Business entity and myself as the Owner/Authorized person:

1. That all information provided in connection with this application is correct. That Section1014, Title 18 U.S. Business code,makes it a federal crime to knowingly make a false statement in this application;

2. That WESTconsin Credit Union is authorized to verify the information provided in this application and to obtain additionalinformation concerning my/our credit worthiness, credit history, financial responsibility and employment history throughany credit bureau or by any lawful means;

3. That this application does not constitute a contract for the extension of credit and that all credit extended to me/us ifmy/our application is approved will be subject to the WESTconsin Business Platinum Visa Credit Card Disclosure containingrules and regulations concerning my/our use of the WESTconsin Business Platinum Visa. A copy of the Disclosure will befurnished to me/us on the approval of this application;

4. That the accounts will be used for business purposes only;

5. That I/we understand and agree that no provision of a marital property agreement, a unilateral statement under s. 766.59Wis. Stats., or a court decree under s. 766.70 Wis. Stats., will affect the interest of WESTconsin adversely, unless prior to thetime credit is granted to the applicants(s), WESTconsin is furnished with a copy of the agreement, statement or decree, orWESTconsin has actual knowledge of the adverse provision. If I am married, a Wisconsin resident, and applying forindividual credit, I understand and agree that credit applied for, if granted will be incurred in the interest of my marriage orfamily. This statement is made in accordance with s. 766.55 (1), Wis. Stats.;

6. RESOLUTION: That the officers, employees and/or agents named above are duly elected, appointed or employed by/or forthe Corporation/Partnership, as the case may be, that the foregoing Resolutions now stand of record on the book of theCorporation/Partnership.

7. GUARANTY: Each individual jointly, separately and unconditionally guarantees payment of and agrees to pay creditor for allcharges and balance on all accounts established with this application; and the undersigned does agree, upon any default inthe making of any payment due by application or breach by application of any covenant or agreement, that theundersigned will, upon request by WESTconsin Credit Union pay the entire unpaid balance, all lawful charges and amountthereunder. Under this Guaranty, the liability of the Guarantor(s) is unlimited, and the obligations of the Guarantor arecontinuing, including any future credit limit increases.

Signature Printed Name Title Date “Applicant/Authorized person as Principal/Owner/Member and Individually as Personal Guarantor”

Signature Printed Name Title Date “Applicant/Authorized person as Principal/Owner/Member and Individually as Personal Guarantor”

Signature Printed Name Title Date “Applicant/Authorized person as Principal/Owner/Member and Individually as Personal Guarantor”

Signature Printed Name Title Date “Applicant/Authorized person as Principal/Owner/Member and Individually as Personal Guarantor”

Approved Credit Limit ________________ BLO initials ____________________ Date _______________

(800) 924-0022 | westconsincu.org Rev. 10.2019 | Page 1 of 2 Federally insured by NCUA

Certification of Beneficial Owners

GENERAL INSTRUCTIONS

What is this form? • To help the government fight financial crime, Federal regulation requires certain financial institutions to obtain,

verify, and record information about the beneficial owners of legal entity customers. Legal entities can be abused to disguise involvement in terrorist financing, money laundering, tax evasion, corruption, fraud, and other financial crimes. Requiring the disclosure of key individuals who own or control a legal entity (i.e., the beneficial owners) helps law enforcement investigate and prosecute these crimes.

Who has to complete this form? • This form must be completed by the person opening a new account on behalf of a legal entity. • For the purposes of this form, a legal entity includes a corporation, limited liability company, or other entity that

is created by a filing of a public document with a Secretary of State or similar office, a general partnership, and any similar business entity formed in the United States or a foreign country. Legal entity does not include sole proprietorships, unincorporated associations, or natural persons opening accounts on their own behalf.

What information do I have to provide? • This form requires you to provide the name, address, date of birth and Social Security number (or passport

number or other similar information, in the case of foreign persons) for the following individuals (i.e., the beneficial owners):

1. Each individual, if any, who owns, directly or indirectly, 25 percent or more of the equity interests of the legal entity customer (e.g., each natural person that owns 25 percent or more of the shares of a corporation); and

2. An individual with significant responsibility for managing the legal entity customer (e.g., a Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice President, or Treasurer).

• The number of individuals that satisfy this definition of “beneficial owner” may vary. Under section (i), depending on the factual circumstances, up to four individuals (but as few as zero) may need to be identified.

• Regardless of the number of individuals identified under section (i), you must provide the identifying information of one individual under section (ii). It is possible that in some circumstances the same individual might be identified under both sections (e.g., the President of Acme, Inc. who also holds a 30% equity interest). Thus, a completed form will contain the identifying information of at least one individual (under section (ii)), and up to five individuals (i.e., one individual under section (ii) and four 25 percent equity holders under section (i)).

• The financial institution may also ask to see a copy of a driver’s license or other identifying document for each beneficial owner listed on this form.

Persons opening an account on behalf of a legal entity must provide the following information:

a. Name and Title of Natural Person Opening Account:

________________________________________________

b. Name, Type and Address of Legal Entity for Which the Account is Being Opened:

________________________________________________

c. The following information for each individual, if any, who, directly or indirectly, through any contract, arrangement, understanding, relationship or otherwise, owns 25 percent or more of the equity interests of the legal entity listed above:

(800) 924-0022 | westconsincu.org Rev. 10.2019 | Page 2 of 2 Federally insured by NCUA

Section (i)

Name Ownership % Date of Birth Address (Res. Or Bus. Street Address) For U.S. Persons 1

For Non-U.S. Persons 2

(If no individual meets this definition, please write “Not Applicable.”)

d. The following information for one individual with significant responsibility for managing the legal entity listed above, such as:

☐ An executive officer or senior manager (e.g., Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice President, Treasurer); or

☐ Any other individual listed who regularly performs similar functions.

(If appropriate, an individual listed under section (i) above may also be listed in the section (ii).

Section (ii)

Name Ownership % Date of Birth Address (Res. Or Bus. Street Address) For U.S. Persons 1

For Non-U.S. Persons 2

I, (name of natural person opening account), hereby certify, to the best of my knowledge that the information provided above is complete and correct, and on behalf of

, I agree to notify the financial institution of any change in such information.

X Natural person opening account Date

1 U.S. Persons must provide a Social Security Number. 2 Non-U.S. Person must provide a Social Security Number, passport number and country of issuance, or similar identification number. In lieu of a passport number, Non-U.S. Person may also provide a Social Security Number, an alien identification card number or a number and country of issuance of any other government-issued document evidencing nationality or residence and bearing a photograph or similar safeguard.

Legal Entity Identifier: (Optional)