Bailey & Galyen Platinum Card Credit Application

Application for a credit card account (“Account”) to be issued by R2S Financial Group, Inc. (“we”, “our”, and “us”). An asterisk (*) indicates a required field.

Application for a credit card account ("Account") to be issued by R2S Financial Group, Inc. ("we", "our", and "us"). An asterisk (*) indicates a required field.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Full Name*

Social Security Number*

Date of Birth*

PLEASE NOTE: HOME ADDRESS MUST MATCH DRIVER'S LICENSE

Street Address*

Address Line 2

City*

State*

ZIP Code*

Rent / Own / Other*

How Long at this Address*

Home Phone Number*

Cell Phone Number*

Email Address*

DRIVER’S LICENSE

Driver’s License Number*

Driver’s License State*

Driver’s License Issued Date*

Driver’s License Exp. Date*

Upload photo of your current driver’s license.*

Max. file size: 50 MB.

EMPLOYMENT

Employer Name*

Position*

How long have you worked there?*

Street Address*

Address Line 2

City*

State*

ZIP Code*

Employer Phone Number*

Annual Income*

Other

Source

Alimony, child support or separate maintenance income need not be revealed if you do not wish to have considered as a basis for repaying this obligation.

Opt Ins*

By clicking here, I represent that I am 18 or older and a US citizen or legal resident; that the information provided in this application is true and correct; that I have read the summary of the key terms and conditions for this Account, including disclosure of key rate provisions; and that I agree to be bound by the terms of the Bailey & Galyen Installment & Credit Agreement ("Agreement"), which is incorporated by reference in this Application and the additional disclosures included with this Application, should this Application be approved.

Untitled*

By providing a telephone number and submitting the form you are consenting to be contacted by SMS text message. Message & data rates may apply. Reply STOP to opt out of further messaging.

I have read the Disclaimer and Privacy Policy.

Date*

To find out about changes in the information in the summary of the key terms and conditions of the Account accompanying, write us at P.O. Box 2304, Hickory, NC 28603. State law requires us to give you the following notices: You give us permission to request a consumer report from consumer reporting agencies in considering this Application and subsequently for the purpose of an update, renewal or extension of credit or reviewing or collecting the Account. Upon your request we will inform applicant of the name and address of each consumer reporting agency from which we obtained a consumer report, if any, relating to Applicant.

To help the government fight the funding of terrorism and money laundering activities, Federal Law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an Account. What this means for you: When you open an Account, we will ask for your name, address, date of birth or other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

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Source

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Campaign

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Keyword

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Medium

Terms & Conditions

The Bailey & Galyen Platinum Card

Cardholder Benefits:

Bailey & Galyen Platinum Card Credit Application

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