#Credit Card Application

Application Information

*I am applying for

*Will there be a co-applicant?

It is our goal to offer you the credit card that best fits your credit profile, which may or may not be the card you originally inquired about. You may be offered a secured card or an unsecured card, which may not include a 3.99% Introductory APR and/or a rewards feature, and with different terms and conditions which will be disclosed to you before your application is processed.

Joint Applicant Information

*Relationship

*Home Phone

Disclosures

This information is given to assist the bank in determining whether to extend credit to me (us). I (we) authorize you to obtain information to check my credit records and statements made in this application. I (we) agree to be bound by the terms of the MasterCard Cardholder Agreement. Applicants shall be jointly and severally liable. All credit will be reported as indicated by signature. First Interstate Bank reserves the right to deny credit to the Applicant(s).

As a condition of granting you a credit card, First Interstate Bank cannot require that you purchase an insurance product from us or any of our affiliates and cannot require your agreement not to obtain or prohibit you from obtaining an insurance product from an unaffiliated entity.

First Interstate Bank reserves the right to increase, decrease or cancel the initial credit line(s) assigned to the Applicant according to First Interstate Bank credit guidelines, account history or the financial circumstances of the Applicant.

This information you supply will be sent encrypted at 128 bit.

*By checking this box I (we) acknowledge that I (we) have read the disclosures and agree to and accept all terms and conditions within disclosures.