Fill and Sign the Notice of Changes to Credit Card Agreement Form

Notice of Changes to Credit Card Agreement Regarding your _____________________ (type of credit card) credit card number ending in: ___________ (last four digits) Notice of Change in Terms to Your Card Agreement Effective on the first day of your billing period starting on or after _________________ (effective date of amendment) (whether or not you receive a billing statement), we are amending your existing Card Agreement and, if applicable, the Credit Card Pricing Supplement, to substitute the following terms regarding the default rate and the late fee, in place of the corresponding ones in your existing Card Agreement. This notice applies to your card ending with the last four numbers listed above. We encourage you to read this notice and save it for future reference. Default Rate: If you default under any Card Agreement that you have with us because you fail to make a payment to us or any other creditor when due, you exceed your credit line, or you make a payment to us that is not honored by your bank, we may increase the ANNUAL PERCENTAGE RATE (including any promotional rate) on all balances to a default rate of Prime Rate plus up to ______ (percentage)%. Factors considered in determining this default rate may include the length of time the account has been open, the existence, seriousness, and timing of Card Agreement defaults, and other indications of account usage and performance. The increase in the annual percentage rate as described in this paragraph takes effect as of the first day of the billing period in which you default. Your account may again become eligible for a lower annual percentage rate on new purchases, new cash advances (including balance transfers), or both after you have met the terms of all Card Agreements for _______ (number) consecutive months. Your existing balances will remain subject to the default rate until they are paid in full. The annual percentage rate in effect and any subsequent changes to it will appear on the billing statement. An increase in the annual percentage rate means you will pay a higher finance charge and perhaps a higher minimum payment. Late Fee: We will add a late fee to the purchase balance for each billing period you fail to make the minimum payment by its due date. We will calculate this late fee as follows: $__________ (dollar amount of first late fee) on balances up to $_________ (maximum dollar amount of first late fee balance), $__________ (dollar amount of second late fee) on balances of $___________ (minimum dollar amount of second late fee balance) up to $___________ (maximum dollar amount of second late fee balance), and $__________ (dollar amount of third late fee) on balances of $___________ (minimum dollar amount of third late fee balance) and over. Non-Acceptance Instructions: If you do not wish to accept the specific changes indicated above, you must notify us in writing by ________________ (due date), stating your non-acceptance. Include your name, address, and account number and mail to: ______________________________ ___________________________________ (mailing address of card issuer) . Upon receipt of your notification of non-acceptance, your account will be closed to further activity and you agree to pay all amounts due as required at the existing pricing terms. If we have not received written notice by the due date or if you use your account after __________________ (due date), you will have agreed to the new terms outlined above which will apply to your account and the entire outstanding balance on your account._______________________(Name of Card Issuer)