Server: Netscape-Commerce/1.12 Date: Friday, 19-Dec-97 20:13:03 GMT Last-modified: Monday, 17-Nov-97 18:55:52 GMT Content-length: 6262 Content-type: text/html Dillard's Online Credit Invitation
Dillard's

Welcome to the Dillard's
Online Credit Invitation


Warning! Any information you submit is unsecure and could be viewed by a third party in transit. If you are transmitting credit card, social security, or any other information you would like to keep private, it would be safer to cancel this application.
The information you submit on this form is for Dillard's use only.
No information will be sold to mailing lists or other services.

Please check type of account desired: Individual - Joint

Name:

Name of Co-Applicant (if joint account):

Relationship of Co-Applicant to Applicant:

Address:

City: State: Zip:

Home Phone: ()

Business Phone: ()

Email Address:

Social Security Number:
Optional: If you do not wish to provide a SS# on this form, you may send in the application anyway. A Dillard's representative will call you and you can provide your SS# at that time.

Date of Birth:
Optional: If you do not wish to provide a Date of Birth on this form, you may send in the application anyway. A Dillard's representative will call you and you can provide your Date of Birth at that time.

Employer:

Credit Reference (check one):

Visa

MasterCard

American Express

Diners Club/Carte Blanche

Discover

Account Number:
Optional: If you do not wish to provide account references on this form, you may send in the application anyway. A Dillard's representative will call you and you can provide your account references at that time.

Expiration date: Month Year

For the purpose of securing credit from you, I certify that the above information is true and complete to the best of my knowledge. I further certify that I have attained The Age of Majority.

I authorize you to check my credit and employment history and to provide and/or obtain information about credit experiences with me.

By submitting this completed form, I acknowledge that I have read and understand the disclosures. I agree that Dillard's may investigate my credit record and that, if an account is opened, they may furnish information regarding this account to credit repo rting agencies and others who may properly request such information.

I (we) agree that if I (we) use or permit another person to use my (our) Dillard's credit card, I (we) will be bound by the terms of the Credit Card Agreement mailed with the card.

The information below concerning the costs of the card described in this application is accurate as of August, 1996. It may have changed since then. To find out what may have changed, write to us at: Dillard National Bank, P.O. Box 52005, Phoenix, AZ 8507 2, Attention: Credit Manager.


Finance Charge Computation - Monthly Rate

The following information applies to residents of all states in the U.S.

Periodic Rate 1.65%
Annual Percentage Rate
19.8%
Method for Computing the Balance for Purchases Average Daily Balance (Including new purchases)
Portion of Average Daily Balance to Which Applied
Entire
Minimum Monthly Finance Charge
$0.50
Grace Period for Repayment of Balances for Purchases
Not Less than 25 Days
Late Fee $20.00


Thank you for completing the Dillard's
Online Credit Invitation.