| Your Name: |
|
| Street Address: |
line
1 |
| |
line
2 |
| |
|
| Home Phone |
(ie:
999-123-4567) |
| Work Phone |
(ie:
999-123-4567) |
| Email Address |
(ie:
yourname@url.com) |
| |
|
| I have an active checking account? |
Yes No |
| Do you have more than $5,000 in unsecured
credit card debt? |
Yes No |
| Are you currently employed? |
Yes
No |
| Do you currently pay rent or own a home? |
Yes
No |
| Do you currently pay an automobile loan or lease? |
Yes
No |
| |
|
| Social Security Number (For ID purpose Only! We do not run a credit check!) |
(ie:
888-55-1234) |
| |
|
| Ever filed for bankruptcy? |
Yes No
|
| If yes, has it been discharged? |
N/A
Yes
No
|
| |
|
| Birthdate |
|
| Total Annual Household Income |
(ie:
$50,000) |
| |
|
| I am at least 18 and a U.S citizen
or permanent resident of the U.S. (excluding
Wisconsin) with a total monthly household income
of at least $800. |
|
Yes No
|
| |
| There is a One-Time Fee to enroll in the Tru Platinum Catalog Shopping Card program. By completing the information, you agree that your checking/savings account will be debited this One-time Fee of $198.00. Once your payment has been processed, we will send you your Tru Platinum Welcome Package. You should allow 7-10 days for funds to clear and 5-7 days for delivery of your Welcome Package. |
 |
| Routing Number |
|
| Bank Account Number |
|
| Account Type |
Checking Savings |
| |
|
| Please enter the approval code
located on your offer letter. If you did not
receive an offer letter in the mail, please
leave blank, and continue with your
registration. |
|
| |
|
| I have read, understand, agree to
and accept the Terms
& Conditions. |
|
