Corporate Credit Card Application

CORPORATE CREDIT CARD APPLICATION

Applicant Information

Employer Identification Number (EIN):   State or Jurisdiction of Formation:   Date of Formation:

Corporation   LLC   Partnership   Sole Proprietorship   Non-profit   Other:

Contact & Address

Main Phone:    Business Email:

Authorized Officer / Primary Signatory

Business Phone:    Email:

Social Security Number (last 4):   Date of Birth:

Requested Card Program

Number of Cards Requested:   Requested Credit Limit Per Card: $   Total Credit Limit Requested: $

Program Features (select all that apply):
Employee cards with individual limits   Centralized billing   Virtual card numbers for vendors   Purchasing controls and merchant blocking

Business Financial Information

Month:   Year:

Bank and Trade References

Account Type:   Account Number (last 4):

Required Attachments (check when attached)

Most recent audited or internally prepared financial statements  
Articles of incorporation or formation  
Voided check or bank letter verifying account  
Other corporate authorization documents (describe below)

Certifications, Authorizations and Terms

The undersigned certifies that the information provided in this application is true, accurate, and complete. The undersigned represents that they are an officer or other authorized representative of the applicant business and have the authority to request the issuance of corporate credit cards and to bind the applicant to the terms and obligations set forth herein.

The applicant authorizes the bank, card issuer and its agents to obtain credit reports and to verify credit, employment, banking and other references in connection with this application. The applicant also authorizes the bank and card issuer to share information about the applicant’s account performance with credit reporting agencies and other third parties as permitted by law.

The applicant acknowledges that card issuance, approval of credit limits, and assessment of fees, charges, and interest are solely at the discretion of the issuer based on underwriting criteria. The applicant agrees to be bound by the cardholder agreement and any program policies supplied upon card issuance. The applicant understands that failure to pay balances when due may result in late fees, interest charges, suspension or cancellation of cards, and other collection remedies permitted by law.

If a personal guarantee is required by the issuer, the undersigned agrees to provide a separate signed personal guaranty and acknowledges that such guaranty will create personal liability for debts incurred under the corporate account. The applicant hereby indemnifies and holds the issuer harmless for any losses arising from the use of issued cards by authorized cardholders, except for liability arising from the issuer's gross negligence.

Governing Law: This application and any resulting account shall be governed by the laws of the state of incorporation of the issuer or as provided in the cardholder agreement. The applicant consents to the jurisdiction of the appropriate state or federal courts for disputes arising from this application or account.

Applicant consents to business credit inquiries and verification.
Authorized officer consents to personal credit inquiries where required for underwriting.

Corporate Resolution & Authorization

The undersigned certifies that the applicant's governing body has duly authorized the filing of this application and the issuance of corporate credit cards. The applicant hereby designates the authorized officer listed above to execute any agreements and to act on behalf of the applicant in all matters relating to the corporate card account.

Meeting Date:    Place of Meeting:

Additional Information

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