APPLICATION OMISSIONS MAY BE GROUNDS

FOR DENIAL.
PLEASE COMPLETE THIS APPLICATION IN DARK BLUE OR BLACK INK.
THE FOLLOWING INFORMATION IS GIVEN FOR THE PURPOSES OF OBTAINING A VISA

CLASSIC

CREDIT LINE DESIRED:

$2,500

$500

$1,000

$1,500

$2,000

ACCOUNT
$3,000

Other $_____________________

APPLICANT INFORMATION
NAME

(FIRST, MIDDLE INITIAL, LAST)

DRIVERS LICENSE NO.

BIRTHDATE

SOCIAL SECURITY NO.

PRESENT ADDRESS

MARITAL STATUS (Check your marital status only if you live in a community property state, such as California.)
MARRIED
STATE/ ZIP

CITY

UNMARRIED
HOW LONG

SEPARATED
PHONE
(
)
NO. OF DEPENDENTS

MAILING ADDRESS (IF DIFFERENT FROM PRESENT ADDRESS)

EMPLOYER

POSITION

HOW LONG

EMPLOYERS ADDRESS

BUS. PHONE

GROSS EMPLOYMENT INCOME

$ MO.

PREVIOUS EMPLOYER (IF LESS THAN 2 YEARS AT PRESENT)

POSITION

HOW LONG

OTHER ADDL INCOME ((NOTE: Alimony, Child Support, Separate maintenance need not be revealed if the applicant or co-applicant do not wish to have it considered as a basis for repayment.)
SOURCE:______________________________________________________ $
SOURCE:______________________________________________________ $
NAME OF NEAREST RELATIVE NOT LIVING WITH YOU
ADDRESS
RELATIONSHIP

CO-APPLICANT/SPOUSE INFORMATION
PROVIDE INFORMATION FOR YOUR SPOUSE ONLY IF A) YOU ARE MARRIED AND RESIDE IN A COMMUNITY PROPERTY STATE, SUCH AS CALIFORNIA, AND ARE APPLYING FOR SEPARATE CREDIT OR B)
B) YOUR SPOUSE IS A CO-APPLICANT.
INFORMATION PROVIDED FOR:
CO-APPLICANT
SPOUSE (NOT A CO-APPLICANT)
SPOUSE (IS A CO-APPLICANT)
NAME

(FIRST, MIDDLE INITIAL, LAST)

DRIVERS LICENSE NO.

RELATIONSHIP TO APPLICANT

SOCIAL SECURITY NO.

PRESENT ADDRESS

BIRTHDATE

MARITAL STATUS (Check your marital status only if you live in a community property state, such as California.)
MARRIED
STATE/ ZIP

CITY

UNMARRIED
HOW LONG

SEPARATED
PHONE
(
)
NO. OF DEPENDENTS

MAILING ADDRESS (IF DIFFERENT FROM PRESENT ADDRESS)

EMPLOYER

POSITION

HOW LONG

EMPLOYERS ADDRESS

BUS. PHONE

GROSS EMPLOYMENT INCOME

$ MO.

PREVIOUS EMPLOYER (IF LESS THAN 2 YEARS AT PRESENT)

POSITION

HOW LONG

OTHER ADDL INCOME (NOTE: Alimony, Child Support, Separate maintenance need not be revealed if the applicant or co-applicant do not wish to have it considered as a basis for repayment.)
SOURCE:______________________________________________________
NAME OF NEAREST RELATIVE NOT LIVING WITH YOU

SOURCE:______________________________________________________
ADDRESS

RELATIONSHIP

FINANCIAL REFERENCES
PROVIDE INFORMATION FOR YOUR SPOUSE ONLY IF A) YOU ARE MARRIED AND RESIDE IN A COMMUNITY PROPERTY STATE, SUCH AS CALIFORNIA, AND ARE APPLYING FOR SEPARATE CREDIT OR
B) YOUR SPOUSE IS A CO-APPLICANT.

APPLICANT

CO-APPLICANT/SPOUSE

OWN HOME

MONTHLY PAYMENT

OWN HOME

LANDLORD OR MORTGATE HOLDER

MONTHLY PAYMENT

LANDLORD OR MORTGATE HOLDER

RENT
$
ASSET INFORMATION
INSTITUTION: ________________________________________________________________
$
CHECKING
SAVINGS
INVESTMENT

RENT
$
ASSET INFORMATION
INSTITUTION: ____________________________________________________________________
$
CHECKING
SAVINGS
INVESTMENT

INSTITUTION: ________________________________________________________________
$
CHECKING
SAVINGS
INVESTMENT

INSTITUTION: ____________________________________________________________________
$
CHECKING
SAVINGS
INVESTMENT

SIGNATURES
I /we represent that the information in this Application is true and complete. I /we authorized East West Bank to make credit inquiries (including employment and deposit verification) to act on my/our application for a Visa credit
card. I/We authorize any person or consumer reporting agency to furnish East West Bank with any information in response to such an inquiry.
I/we agree to be bound by the Visa Classic Agreement and Initial Disclosures received with my card, except as otherwise provided by law. Each person signing this application will be obligated according to the terms of the Visa
Classic Agreement and Initial Disclosures.

X
Signature of Applicant

Date

Signature of Co-Applicant

Date

SECURITY AGREEMENT (SECURED VISA ONLY)

I/we have requested the issuance of a secured Visa. As collateral for credit extended to me/us on my/our Visa credit card, I/we have deposited funds in an account no. ______________________________ at East West Bank in an
amount equal to 200% of the line limit. I/we acknowledge that upon termination of this Visa, funds may be held for a minimum period of 45 days after termination to allow for all charges to be processed and that East West Bank
shall return such funds and any interest thereon only to the holder of the collateral account. I/we also understand that East West Bank has the right to revoke this credit line extended to me/us by providing me/us with such notice as
required by law. I/we also understand that East West Bank may, without notice, withdraw, set off and/or apply any such funds to the repayment of any amounts due on the account in the event of default.

X
Signature of Applicant

Date

Signature of Co-Applicant

Date

Please see the enclosed Important Disclosures for rate, fee, and other cost information.
PLEASE DO NOT WRITE BELOW THIS LINE
NEW
LIMIT INCREASE

REISSUE
BALANCE TRANSFER

Type Card

Approved

File #
Agent #

Bank #
Date

CO-SIGNER
264628405.doc

ADD CARDHOLDER

Account #

Limit
Rev .5/2013