Apply for a Velocity Micro® Credit Card - Purchase a High-Performance Computer System

				1-800-303-7866

Velocity Micro Credit Application
This application asks for information that will allow us to identify you. All fields are required.

If you wish to enter your information on our secure server, click here.

Name: First:

MI:

Last Name:

Suffix:

Address:

City:

State:

Zip:

Social Security #:

How Long at Present Address (years):

Own Rent

Birth date (MM/DD/YYYY):

# of Dependents:

Home Phone:

Work Phone:

Employer:

# Years:

Occupation:

# of Years:

Income per Month:

Household Income/Month:

Alimony, child-support or separate maintenance income need not be revealed if you do not wish to have it considered for this Application.

Checking Account?:

Yes No

Savings Account?:

Yes No

Bank name:

Reference/Relative:

Phone:

Your Email Address:

IMPORTANT CREDIT INFORMATION

This is an application with CrediCard National Bank for a Velocity Micro credit card.

The information below includes the costs associated with an Account. It is accurate as of March 2004, but may change after that date. To learn what may have changed, you may write to: CrediCard National Bank, 100 West Olmos Drive, Suite 200, San Antonio, TX 78212.

Annual Percentage Rate

The annual percentage rate is 18%
This translates to a monthly periodic rate of 1.50%.

Grace Period To Repay Balance

You have 25 days from your billing date to repay your balance before being charged a finance charge. Deferred billing options, when offered, carry an extended grace period.

Balance Calculation Method

The Average Daily Balance method (including new transactions) is used.

Minimum Finance Charge

A minimum monthly finance charge of $.50 applies.

Late Payment Fees

You may be charged and you agree to pay a Late Payment Fee of 5% of the past due amount or $15.00, whichever is less.

Minimum Amount Due

When the Outstanding Balance Reaches:	The Minimum Amount Due Will be:
$.01 to $25.00 .....	Outstanding Balance.
Over $25.00 .....	3% of the Outstanding Balance or $25.00, whichever is greater.

AGREEMENT. I have read the Important Credit Information for this account and, by electronically transmitting this application (click I Agree below), I indicate my agreement with each of the Terms and Conditions. I understand that I will be bound by each of the terms of the Credit Card Account and Security Agreement.

I have read this application, and everything I have stated is true. I am at least 18 years of age and either a United States citizen or a permanent resident of the U.S. or Puerto Rico. I authorize CrediCard National Bank (CCNB) to review my credit and employment histories and any other information in order to process this application, service my account, and manage its relationship with me. I consent to CCNB's sharing of information about me and my account with the Merchant. I authorize CCNB to share with others, to the extent permitted by law, such information and its credit experience with me. The CCNB Privacy Notice is available online and will accompany the credit card when it is mailed.