0% INTEREST FOR 12 MONTHS*** ***For qualified buyers 1. APPLICANT INFORMATION: Please tell us about yourself. Name(First-Middle-Last) Please Print Date of Birth Please leave this field empty. Social Security Number Home Phone Number Mailing Address Apt# City State ZIP Cell/Other Phone Number If the above address is a P.O Box Contact Person Name You must provide a street address yourself or a contact person Street Address(Street Name and Number) Your Address City Contact Person State ZIP Housing Information PARENTS/RELATIVEOWNRENTOTHER Alimony, child support or seprate maintenance income need not be included unless relied upon for credit. You may include the monthly amount that you have available to spend from your assets. Monthly Net Income From all Sources. Employer's Phone Number Relative Phone Number Email Address(optional) 2. JOINT APPLICANT INFORMATION: Name(First-Middle-Last) Please Print Date of Birth Social Security Number Home Phone Number Mailing Address Apt# City State ZIP Cell/Other Phone Number If the above address is a P.O Box Contact Person Name You must provide a street address yourself or a contact person Street Address(Street Name and Number) Your Address City Contact Person State ZIP Housing Information PARENTS/RELATIVEOWNRENTOTHER Alimony, child support, or separate maintenance income need not be included unless relied upon for credit. You may include the monthly amount that you have available to spend from your assets. Monthly Net Income From all Sources. Employer's Phone Number Relative Phone Number Email Address(optional) 3. APPLICANT and JOINT APPLICANT: We need your signature(s) below By applying for this account, I am asking Synchrony Bank (“SYNCB”) to issue me a SYNCB credit card (the “Card”), and I agree that: I am providing the information in this application to SYNCB and to dealers/merchants/retailers that accept the Card and program sponsors (and their respective affiliates). I also provide my consent for SYNCB to provide information about me (even if my application is declined) to dealers/merchants/retailers that accept the Card and program sponsors (and their respective affiliates) so that they can create and update their records, and provide me with service and special offers. SYNCB may obtain information from others about me (including requesting reports from consumer reporting agencies and other sources) to evaluate my application, and to review, maintain or collect my account. I consent to SYNCB and any other owner or servicer of my account contacting me about my account, including using any contact information or cell phone numbers I provide, and I consent to the use of any automatic telephone dialing system and/or an artificial or prerecorded voice when contacting me, even if I am charged for the call under my phone plan. I have received, read and agree to the credit terms and other disclosures in this application, and I understand that if my application is approved, the SYNCB credit card account agreement (“Agreement”) will be sent to me and will govern my account. Among other things, the Agreement: (1) includes a resolving a dispute with arbitration provision that limits my rights unless I reject the provision by following the provision’s instructions; and (2) makes each applicant responsible for paying the entire amount of the credit extended. PLEASE SEE THE ATTACHED CREDIT CARD AGREEMENT FOR RATES, FEES AND OTHER COST INFORMATION. Federal law requires SYNCB to obtain, verify and record information that identifies you when you open an account. SYNCB will use your name, address, date of birth, and other information for this purpose. If you apply with a Joint Applicant, each of you will be jointly and individually responsible for obligations under the Agreement and by signing below, you each agree that you intend to apply for joint credit. 3. APPLICANT and JOINT APPLICANT: FOR RETAILER USE ONLY(Validation of Customer ID VERIFIED BY# RETAILER# ACCOUNT# KEY# AMOUNT OF INITIAL TRANSACTION Applicant 1st ID TYPE/NUMBER Driver's LicenseState issuedFederal Goverment ISSUANCE STATE Exp Date: Applicant 2nd ID (CREDIT CARD TYPE & ISSUER) Exp Date: Joint Applicant 1st ID TYPE/NUMBER Driver's LicenseState issuedFederal Goverment ISSUANCE STATE Exp Date: Joint Applicant 2st ID (CREDIT CARD TYPE & ISSUER) Exp Date: RETAILER PHONE RETAILER FAX APPLICANT SIGNATURE MATCH YESNO APPLICANT PHOTO MATCH YESNO PLEASE READ THE ATTACHED SYNCHRONY BANK CREDIT CARD ACCOUNT AGREEMENT BEFORE SIGNING THIS APPLICATION
