Visa Rewards Application

Visa Rewards
Service Area

Better Banks is currently accepting applications from existing customers and residents within the Illinois counties of Fulton, Henry, Marshall, McLean, Peoria, Stark, Tazewell, and Woodford. You must also be a US citizen to apply.
Are you a new customer to Better Banks?*

Yes, I am a new customer.No, I am a current customer.
County you reside in:*
What is your desired credit limit?*
Card Limit Minimum: $500
Have you previously received credit from us?*

YesNo

Personal Information
Important Information about Procedures for Opening a New Account:

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

First NameLast Name
Social Security Number*
Date of Birth*

MonthDayYear
Phone Number*
Please enter a valid phone number.
Email*
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code

Employment

Current Employer
Do you have employment?*

YesNoRetiredOther
Other: Please explain*
Employer's Name*
Employer's Phone Number*
Employer's Address*

Street Address

Street Address Line 2

CityState

Zip Code
Your Position*
Years at Company*
Gross Salary per Month*
Net Salary per Month*
Other Income Sources

* You need not furnish alimony, child support, or maintenance income if you do not want us to consider it in evaluating your application.
Other Income**

YesNo
Sources of Other Income*
Amount Per Month*
Is any income listed likely to be reduced before the credit request is paid off?*

YesNo

Living Expenses
Do you own, rent, or other?*

OwnRentOther
Other: Please explain*
Mortgage Holder*
Monthly Payment*
Monthly housing expenses, rent, or mortgage payment including taxes and insurance. If no expenses, enter "none".
Would you like to add a co-applicant?*

YesNo

Co-Applicant Employment

Current Employer
Do you have employment?*

YesNoRetiredOther
Other: Please explain*
Employer's Name*
Employer's Phone Number*
Please enter a valid phone number.
Employer's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Co-Applicant's Position*
Years at Company*
Gross Salary per Month*
Net Salary per Month*
Other Income Sources

* You need not furnish alimony, child support, or maintenance income if you do not want us to consider it in evaluating your application.
Other Income**

YesNo
Sources of Other Income*
Amount Per Month*
Is any income listed likely to be reduced before the credit request is paid off?*

YesNo

Visa Rewards