Credit Card Application

Star Tech FCU Credit Card Application

Primary Account Holder

Applicant's name (First, M, Last) *

Birthday*

Social Security Number*

Driver's License Number

Driver's License State

Present Address*

Home Phone*

Business Phone

Email Address*

Employment information

Current Employer *

Position *

Annual Income *

Employee Start Date *

Credit information

Residence
Own Rent Lives with relatives

Present Mortgage Co., Landlord, or Relative

Monthly Mortgage/Rent Payment (includes taxes and insurance)

Current Value * If you own your home, what is the current value?

Mortgage Balance

Have you ever had a car or other personal property repossessed by a dealer or finance company, filed for bankruptcy, or been a party to a wage assignment or collection suit, or have you ever been declined on a loan application with this credit union? * Yes No

Reference

Name of nearest relative not living with you *

Reference Address*

Relationship *

Phone *