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G-10(A) Applications and Solicitations Model Form (Credit Cards)
Interest Rates and Interest Charges
Annual Percentage Rate
(APR) for Purchases

[Purchase rate]
[Description that rate varies and how it is determined, if applicable]

APR for Balance Transfers

[Balance transfer rate]
[Description that rate varies and how it is determined, if applicable]
[Statement about balance transfer fee and cross reference, if applicable]
[Payment allocation notice, if applicable]

APR for Cash Advances

[Cash advance rate]
[Description that rate varies and how it is determined, if applicable]
[Statement about cash advance fee and cross reference, if applicable]
[Payment allocation notice, if applicable]

Penalty APR and When it
Applies

[Penalty rate]
[Description of events that may result in the penalty rate]
[Description of how long penalty rate may apply]

[Minimum Interest
Charge]/[Minimum
Charge]

[Description of minimum interest charge or minimum charge]

Grace Period on
Purchases

[Description of grace period for purchases or statement that no grace period applies]

Website for Additional
Information

[Reference to Board’s website]

Fees
[Annual Fee]/[Set-up and
Maintenance Fees]

[Notice of available credit, if applicable]
[Description of fees for availability or issuance of credit, such as an annual fee, if
applicable]

Transaction Fees
• Balance Transfer

[Description of balance transfer fee]

• Cash Advance

[Description of cash advance fee]

Penalty Fees
• Late Payment

[Description of late payment fee] [Cross reference to penalty rate, if applicable]

• Over-the-Credit Limit

[Description of over-the-credit limit fee] [Cross reference to penalty rate, if applicable]

• Returned Payment

[Description of returned payment fee] [Cross reference to penalty rate, if applicable]

Other Fees
• Required [insert name

of required insurance,
or debt cancellation or
suspension coverage]

[Description of cost of insurance, or debt cancellation or suspension plans] [Cross
reference to additional information, if applicable]

Balance Computation Method: [Description of balance computation method]

G-10(B) Applications and Solicitations Sample (Credit Cards)
Interest Rates and Interest Charges
Annual Percentage Rate
(APR) for Purchases

8.99% to 19.99% when you open your account, based on your
creditworthiness.
After that, your APR will vary with the market based on the Prime Rate.

APR for Balance
Transfers

0.00% (Intro. APR through your December 2007 billing cycle)
15.99% (APR after December 2007)
Balance transfer fees will also apply (see Fees section below).
Notice Regarding Interest Charges: Your introductory APR applies only to
balance transfers, not to purchases. During the introductory period we will apply
your payments to transferred balances before we apply them to any purchases you
make. You will be charged interest on all purchases until your entire balance has
been paid off completely, including transferred balances.

APR for Cash Advances

21.99%
This APR will vary with the market based on the Prime Rate.
Cash advance fees will also apply (see Fees section below).

Penalty APR and When it
Applies

28.99%
This APR may be applied to the entire balance on your account if you:
1) Make a late payment twice in a six-month period;
2) Go over your credit limit twice in a six-month period;
3) Make a payment that is returned; or
4) Do any of the above on another account that you have with us.
How Long Will the Penalty APR Apply?: If your APRs are increased for any of
these reasons, the Penalty APR will apply until you make six consecutive minimum
payments when due and do not exceed your credit limit during that time period.

Minimum Interest
Charge

If you are charged interest, the charge will be no less than $1.00.

Grace Period on
Purchases

If you pay your entire balance in full each month, you have at least 25 days after the
close of each period to pay your balance on purchases without being charged interest.

Website for Additional
Information

To learn more about factors to consider when applying for or using a credit card, visit
the website of the Federal Reserve Board at http://www.frb.gov/location.

Fees
Annual Fee

None

Transaction Fees
• Balance Transfer

Either $5 or 3% of the amount of each transfer, whichever is greater (maximum fee:
$100).

• Cash Advance

Either $5 or 3% of the amount of each cash advance, whichever is greater.

Penalty Fees
• Late Payment

$29 if balance is less than or equal to $1,000;
$35 if balance is more than $1,000 (Your APRs may also increase; see Penalty APR
section above.)

• Over-the-Credit Limit

$29 (Your APRs may also increase; see Penalty APR section above.)

• Returned Payment

$35 (Your APRs may also increase; see Penalty APR section above.)

Other Fees
• Required Account

$0.79 per $100 of balance at the end of each statement period. See back for details.

Protector Plan
How We Will Calculate Your Balance: We use a method called "average daily balance (including new purchases)."

G-10(C) Applications and Solicitations Sample (Credit Cards)
Interest Rates and Interest Charges
Annual Percentage Rate
(APR) for Purchases

8.99%, 12.99%, or 19.99% when you open your account, based on
your creditworthiness.
After that, your APR will vary with the market based on the Prime Rate.

APR for Balance Transfers

0.00% (Intro. APR through your December 2007 billing cycle)
15.99% (APR after December 2007)
Balance transfer fees will also apply (see Fees section below).
Notice Regarding Interest Charges: Your introductory APR applies only to balance
transfers, not to purchases. During the introductory period we will apply your
payments to transferred balances before we apply them to any purchases you make.
You will be charged interest on all purchases until your entire balance has been paid
off completely, including transferred balances.

APR for Cash Advances

21.99%
This APR will vary with the market based on the Prime Rate.
Cash advance fees will also apply (see Fees section below).

Penalty APR and When it
Applies

28.99%
This APR may be applied to the entire balance on your account if you:
1) Make a late payment;
2) Go over your credit limit;
3) Make a payment that is returned; or
4) Do any of the above on another account that you have with us.
How Long Will the Penalty APR Apply?: If your APRs are increased for any of
these reasons, we may keep them at this higher level indefinitely.

Minimum Interest Charge

If you are charged interest, the charge will be no less than $0.50.

Grace Period on
Purchases

If you pay your entire balance in full each month, you have at least 25 days after the
close of each period to pay your balance on purchases without being charged interest.

Website for Additional
Information

To learn more about factors to consider when applying for or using a credit card, visit
the website of the Federal Reserve Board at http://www.frb.gov/location.

Fees
Set-up and Maintenance
Fees

NOTICE: Some of these set-up and maintenance fees will be assessed before you
begin using your card and will reduce the amount of credit you initially have available.
For example, if you are assigned the minimum credit limit of $250, your initial available
credit will be only $68 (or $53 if you choose to have an additional card).

• Annual Fee

$60

• Account Set-up Fee

$30 (one-time fee)

• Program Fee

$85 (one-time fee)

• Participation Fee

$84 annually ($7 per month)

• Additional Card Fee

$15 annually (if applicable)

• Account Maintenance

$60 annually ($5 per month on closed accounts with an outstanding balance of $30 or
more)

Fee on Closed Accounts
Transaction Fees
• Balance Transfer

Either $5 or 3% of the amount of each transfer, whichever is greater (maximum fee:
$100).

• Cash Advance

Either $5 or 3% of the amount of each cash advance, whichever is greater.

Penalty Fees
• Late Payment

$29 if balance is less than or equal to $1,000;
$35 if balance is more than $1,000 (Your APRs may also increase; see Penalty APR
section above.)

• Over-the-Credit Limit

$29 (Your APRs may also increase; see Penalty APR section above.)

• Returned Payment

$35 (Your APRs may also increase; see Penalty APR section above.)

How We Will Calculate Your Balance: We use a method called "average daily balance (including new purchases)."

G-10(D) Applications and Solicitations Model Form (Charge Cards)
Payment Information
[A statement that charges incurred through use of the charge card are due when the periodic statement is received]

Fees
[Annual Fee]/[Set-up and
Maintenance Fees]

[Notice of available credit, if applicable]
[Description of fees for availability or issuance of credit, such as an annual fee, if
applicable]

Transaction Fees
• Balance Transfer

[Description of balance transfer fee]

• Cash Advance

[Description of cash advance fee]

Penalty Fees
• Late Payment

[Description of late payment fee]

• Over-the-Credit Limit

[Description of over-the-credit limit fee]

• Returned Payment

[Description of returned payment fee]

G-10(E) Applications and Solicitations Sample (Charge Cards)
Payment Information
All charges made on this charge card are due and payable when you receive your periodic statement.

Fees
Annual Fee

$50

Transaction Fees
• Balance Transfer

Either $5 or 3% of the amount of each transfer, whichever is greater (maximum fee:
$100).

• Cash Advance

Either $5 or 3% of the amount of each cash advance, whichever is greater.

Penalty Fees
• Late Payment

$31 if balance is less than or equal to $1,000;
$35 if balance is more than $1,000

• Over-the-Credit Limit

$30

• Returned Payment

$30

G-17(A) Account-opening Model Form
Interest Rates and Interest Charges
Annual Percentage Rate
(APR) for Purchases

[Purchase rate]
[Description that rate varies and how it is determined, if applicable]

APR for Balance Transfers

[Balance transfer rate]
[Description that rate varies and how it is determined, if applicable]
[Statement about balance transfer fee and cross reference, if applicable]
[Payment allocation notice, if applicable]

APR for Cash Advances

[Cash advance rate]
[Description that rate varies and how it is determined, if applicable]
[Statement about cash advance fee and cross reference, if applicable]
[Payment allocation notice, if applicable]

Penalty APR and When it
Applies

[Penalty rate]
[Description of events that may result in the penalty rate]
[Description of how long penalty rate may apply]

[Minimum Interest
Charge]/[Minimum
Charge]

[Description of minimum interest charge or minimum charge]

Grace Period

[Description of grace period for purchases, cash advances, balance transfers or any
other credit extended or statement that no grace period applies]

Website for Additional
Information

[Reference to Board’s website]

Fees
[Annual Fee]/[Set-up and
Maintenance Fees]

[Notice of available credit, if applicable]
[Description of fees for availability or issuance of credit, such as an annual fee, if
applicable]

Transaction Fees
• Balance Transfer

[Description of balance transfer fee]

• Cash Advance

[Description of cash advance fee]

• Foreign Transaction

[Description of foreign transaction fee]

Penalty Fees
• Late Payment

[Description of late payment fee] [Cross reference to penalty rate, if applicable]

• Over-the-Credit Limit

[Description of over-the-credit limit fee] [Cross reference to penalty rate, if applicable]

• Returned Payment

[Description of returned payment fee] [Cross reference to penalty rate, if applicable]

Other Fees
• Required [insert name

of required insurance,
or debt cancellation or
suspension coverage]

[Description of cost of insurance, or debt cancellation or suspension plans] [Cross
reference to additional information, if applicable]

Balance Computation Method: [Description of balance computation method] [Reference to account agreement for more
details]
Billing Rights: [Reference to account agreement for details on billing-error rights]

G-17(B) Account-opening Sample
Interest Rates and Interest Charges
Annual Percentage Rate
(APR) for Purchases

8.99%
This APR will vary with the market based on the Prime Rate.

APR for Balance
Transfers

0.00% (Intro. APR through your December 2007 billing cycle)
15.99% (APR after December 2007)
Balance transfer fees will also apply (see Fees section below).
Notice Regarding Interest Charges: Your introductory APR applies only to
balance transfers, not to purchases. During the introductory period we will apply
your payments to transferred balances before we apply them to any purchases you
make. You will be charged interest on all purchases until your entire balance has
been paid off completely, including transferred balances.

APR for Cash Advances

21.99%
This APR will vary with the market based on the Prime Rate.
Cash advance fees will also apply (see Fees section below).

Penalty APR and When it
Applies

28.99%
This APR may be applied to the entire balance on your account if you:
1) Make a late payment twice in a six-month period;
2) Go over your credit limit twice in a six-month period;
3) Make a payment that is returned; or
4) Do any of the above on another account that you have with us.
How Long Will the Penalty APR Apply?: If your APRs are increased for any of
these reasons, the Penalty APR will apply until you make six consecutive minimum
payments when due and do not exceed your credit limit during that time period.

Minimum Interest Charge

If you are charged interest, the charge will be no less than $1.00.

Grace Period

If you pay your entire balance in full each month, you have at least 25 days after the
close of each period to pay your balance on purchases without being charged interest.
There is no grace period for cash advances and balance transfers.

Website for Additional
Information

To learn more about factors to consider when applying for or using a credit card, visit
the website of the Federal Reserve Board at http://www.frb.gov/location.

Fees
Annual Fee

None

Transaction Fees
• Balance Transfer

Either $5 or 3% of the amount of each transfer, whichever is greater (maximum fee:
$100).

• Cash Advance

Either $5 or 3% of the amount of each cash advance, whichever is greater.

• Foreign Transaction

2% of each transaction in U.S. dollars

Penalty Fees
• Late Payment

$29 if balance is less than or equal to $1,000;
$35 if balance is more than $1,000 (Your APRs may also increase; see Penalty APR
section above.)

• Over-the-Credit Limit

$29 (Your APRs may also increase; see Penalty APR section above.)

• Returned Payment

$35 (Your APRs may also increase; see Penalty APR section above.)

Other Fees
• Required Account

$0.79 per $100 of balance at the end of each statement period. See back for details.

Protector Plan
How We Will Calculate Your Balance: We use a method called "average daily balance (including new purchases)."
See your account agreement for more details.
Billing Rights: Information on your rights to dispute transactions and how to exercise those rights is provided in your
account agreement.

G-17(C) Account-opening Sample
Interest Rates and Interest Charges
Annual Percentage Rate
(APR) for Purchases

8.99%

APR for Balance Transfers

0.00% (Intro. APR through your December 2007 billing cycle)
15.99% (APR after December 2007)

This APR will vary with the market based on the Prime Rate.

Balance transfer fees will also apply (see Fees section below).
Notice Regarding Interest Charges: Your introductory APR applies only to
balance transfers, not to purchases. During the introductory period we will apply
your payments to transferred balances before we apply them to any purchases
you make. You will be charged interest on all purchases until your entire balance
has been paid off completely, including transferred balances.
APR for Cash Advances

21.99%
This APR will vary with the market based on the Prime Rate.
Cash advance fees will also apply (see Fees section below).

Penalty APR and When it
Applies

28.99%
This APR may be applied to the entire balance on your account if you:
1) Make a late payment;
2) Go over your credit limit;
3) Make a payment that is returned; or
4) Do any of the above on another account that you have with us.
How Long Will the Penalty APR Apply?: If your APRs are increased for any of
these reasons, we may keep them at this higher level indefinitely.

Minimum Interest Charge

If you are charged interest, the charge will be no less than $0.50.

Grace Period

If you pay your entire balance in full each month, you have at least 25 days after the
close of each period to pay your balance on purchases without being charged
interest. There is no grace period for cash advances or balance transfers.

Website for Additional
Information

To learn more about factors to consider when applying for or using a credit card, visit
the website of the Federal Reserve Board at http://www.frb.gov/location.

Fees
Set-up and Maintenance
Fees

NOTICE: Some of these set-up and maintenance fees will be assessed before you
begin using your card and will reduce the amount of credit you initially have available.
For example, if you are assigned the minimum credit limit of $250, your initial
available credit will be only $68 (or $53 if you choose to have an additional card).

x Annual Fee

$60

x Account Set-up Fee

$30 (one-time fee)

x Program Fee

$85 (one-time fee)

x Participation Fee

$84 annually ($7 per month)

x Additional Card Fee

$15 annually (if applicable)

x Account Maintenance Fee

$60 annually ($5 per month on closed accounts with an outstanding balance of $30 or
more)

on Closed Accounts

Transaction Fees
x Balance Transfer

Either $5 or 3% of the amount of each transfer, whichever is greater (maximum fee:
$100).

x Cash Advance

Either $5 or 3% of the amount of each cash advance, whichever is greater.

x Foreign Transaction

2% of each transaction in U.S. dollars.

Penalty Fees
x Late Payment

$29 if balance is less than or equal to $1,000;
$35 if balance is more than $1,000 (Your APRs may also increase; see Penalty APR
section above.)

x Over-the-Credit Limit

$29 (Your APRs may also increase; see Penalty APR section above.)

x Returned Payment

$35 (Your APRs may also increase; see Penalty APR section above.)

How We Will Calculate Your Balance: We use a method called "average daily balance (including new
purchases)." See your account agreement for more details.
Billing Rights: Information on your rights to dispute transactions and how to exercise those rights is provided in
your account agreement.

G-18(A) Periodic Statement Transactions; Interest Charges; Fees Sample
Transactions
Reference Number

Trans Date

854338203fs8oo0z5
045148714518979874

2/25
3/4

5884186Ps0388w6Ym
0544400060zlv72vl
55541860705rdYd0x
554328608008w90m0
054830709lYmrPT4l
564891561545KosHd
841517877845AKoJIo
895848561561894KoH
1871556189456sAmKl
2564894185189lKdfId
2564561023184102315

2/22
2/24
2/25
2/25
2/25
2/25
2/25
2/26
2/26
2/27
2/28

Post Date
Description of Transaction or Credit
Payments and Other Credits
2/25
Pymt Thank You
3/5
store #13
Purchases
2/23
store #1
2/25
store #2
2/26
store #3
2/26
store #4
2/26
store #5
2/26
store #6
2/26
store #7
2/27
store #8
2/27
store #9
2/28
store #10
3/1
store #11

Amount
$450.00–
$13.45–
$2.05
$12.11
$4.63
$114.95
$7.35
$14.35
$40.35
$27.68
$124.76
$32.87
$14.76

55542818705rAsd0x

3/1

3/2

store #12

$3.76

289189194Asds8744

3/1

3/3

store #13

$13.45

178105417841045784

3/2

3/4

store #14

$2.35

8456152156181sdsA

3/5

3/6

store #15

$25.00

31289105205648Awd

3/11

3/12

store #16

$7.34

04518478415615Asd

3/11

3/16

store #17

$10.56
$24.50

0547810544898718Af

3/15

3/17

store #18

056489413216848oP

3/16

3/17

store #19

$8.76

054894561564Asdw

3/17

3/18

store #20

$14.23

5648974891Ad98156

3/19

3/20

store #21

$23.76

Cash Advances
1542202074Twwzv48

2/26

2/26

Cash Advance

$121.50

14547847586Kddl564

2/28

2/28

Cash Advance

$196.50

Balance Transfers
4545754784KoHUIos

2/27

3/1

Balance Transfer

$785.00

9525156489sfd4545Q

2/23

2/23

late fee

56415615647oJsNds

2/26

2/26

Cash Advance fee *Transaction fee*

84151564sAds8745H

2/27

2/27

Balance Transfer fee *Transaction fee*

256489156189451516l

2/28

2/28

Cash Advance fee *Transaction fee*

Fees
$35.00

TOTAL FEES FOR THIS PERIOD

$5.00
$23.55
$5.90
$69.45

Interest Charged
Interest Charge on Purchases
Interest Charge on Cash Advances
TOTAL INTEREST FOR THIS PERIOD

2007 Totals Year-to-Date
Total fees charged in 2007

$90.14

Total interest charged in 2007

$18.27

$6.31
$4.58
$10.89

G-18(B) Periodic Statement Fee-Inclusive APR Sample
Fee-Inclusive APR
The Fee-Inclusive APRs in this table are the APRs that you paid this period when transaction or fixed fees are taken into
account as well as interest.
Type of Balance

Interest Charges

Transaction or
Fixed Fees

Fee-Inclusive APR

Purchases

$6.31

$0.00

14.99%

Cash Advances

$4.58

$10.90

58.42%

Balance Transfers

$0.00

$23.55

36.00%

G-18(E) Periodic Statement New Balance, Due Date, Late Payment and
Minimum Payment Sample (Credit Cards)
Payment Information
New Balance
Minimum Payment Due
Payment Due Date

$1,784.53
$48.00
4/20/07 (before 2:00 pm)

Late Payment Warning: If we do not receive your
minimum payment by the date listed above, you may have
to pay a $35 late fee and your APRs may be increased up
to the Penalty APR of 28.99%.
Notice about Minimum Payments: If you make only the
minimum payment each period, you will pay more in interest
and it will take you longer to pay off your balance. For example,
if you had a balance of $1,000 at an interest rate of 17%
and always paid only the minimum required, it would take
over 7 years to repay this balance. For an estimate of the
time it would take to repay your actual balance making only
minimum payments, call 1-800-XXX-XXXX.

G-18(F) Periodic Statement New Balance, Due Date and
Late Payment Sample (Open-End Plans (Non-credit-card Accounts))

Payment Information
New Balance
Minimum Payment Due
Payment Due Date

$1,784.53
$48.00
4/20/07 (before 2:00 pm)

Late Payment Warning: If we do not receive your
minimum payment by the date listed above, you may have
to pay a $35 late fee and your APRs may be increased up
to the Penalty APR of 28.99%.

G-18(G) Periodic Statement Form

Page 1 of 2

XXX Bank Credit Card Account Statement
Account Number XXXX XXXX XXXX XXXX
February 21, 2007 to March 22, 2007
Payment Information

Summary of Account Activity
Previous Balance
Payments
Other Credits
Purchases
Balance Transfers
Cash Advances
Past Due Amount
Fees Charged
Interest Charged

$535.07
-$450.00
-$13.45
+$529.57
+$785.00
+$318.00
+$0.00
+$69.45
+$10.89

New Balance

$1,784.53

Credit limit
Available credit
Statement closing date
Days in billing cycle

$2,000.00
$215.47
3/22/2007
30

QUESTIONS?
Call Customer Service
lost or Stolen Credit Card

New Balance

$1,784.53

Minimum Payment Due

$48.00

Payment Due Date

4/20/07 (before 2:00 pm)

Late Payment Warning: If we do not receive your
minimum payment by the date listed above, you may have
to pay a $35 late fee and your APRs may be increased up
to the Penalty APR of 28.99%.
Notice about Minimum Payments: If you make only the
minimum payment each period, you will pay more in interest
and it will take you longer to pay off your balance. For example,
if you had a balance of $1,000 at an interest rate of 17%
and always paid only the minimum required, it would take
over 7 years to repay this balance. For an estimate of the
time it would take to repay your actual balance making only
minimum payments, call 1-800-XXX-XXXX.
Please send billing inquiries and correspondence to:
PO Box XXXX, Anytown, Anystate XXXXX

1-XXX-XXX-XXXX
1-XXX-XXX-XXXX

Important Changes to Your Account Terms
The following is a summary of changes that are being made to your account terms. You have the right to opt out of these
changes. For more detailed information, please refer to the booklet enclosed with this statement. The effective date of
these changes is 5/10/07. Note: The change to your APR for purchases described below wil not go into effect at this time
if you are already being charged a higher Penalty APR on purchases. This change will go into effect when the Penalty APR
no longer applies.

Revised Terms, as of 5/10/07
APR for Purchases

16.99%
$32 if your balance is less than or equal to $1,000;
$39 if your balance is more than $1,000

Late Payment Fee

Transactions
Reference Number

Trans Date

854338203FS8OO0z5
045148714518979874

2/25
3/4

5884186PS0388w6YM
0544400060zlV72Vl
55541860705RDYD0X
554328608008w90M0
054830709lYMRPT4l
564891561545KOSHD
841517877845AKOJIO
895848561561894KOH
1871556189456SAMKl
2564894185189lKDFID

2/22
2/24
2/24
2/24
2/24
2/25
2/25
2/26
2/26
2/27

Post Date
Description of Transaction or Credit
Amount
Payments and Other Credits
2/25
Pymt Thank You
$450.00–
3/5
Store #13
$13.45–
Purchases
2/23
Store #1
$2.05
2/25
Store #2
$12.11
2/25
Store #3
$4.63
2/25
Store #4
$114.95
2/25
Store #5
$7.35
2/26
Store #6
$14.35
2/26
Store #7
$40.35
2/27
Store #8
$27.68
2/27
Store #9
$124.76
2/28
Store #10
$32.87
(transactions continued on next page)

NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION
Page 1 of 2

Please detach this portion and return with your payment to insure proper credit. Retain upper portion for your records.

Please indicate address change and additional
cardholder requests on the reverse side.

Account Number:

XXXX XXXX XXXX XXXX

New Balance

$1,784.53

Minimum Payment Due

$48.00

Payment Due Date

4/20/07 (before 2:00 pm)

AMOUNT ENCLOSED: $

XXX Bank
P.O. Box XXXX
Anytown, Anystate XXXXX

l l l l ll lll llll ll ll llllll ll llll llll ll llll llll lllll

l l l lll lll lll

ll ll

ll ll l l l ll l lll llll ll ll ll lll llll ll

ll l lllll l lll lll ll l ll llll

XXX Bank Credit Card Account Statement
Account Number XXXX XXXX XXXX XXXX
February 21, 2007 to March 22, 2007

Page 2 of 2

Transactions (cont.)
Reference Number

Trans Date

2564561023184102315
55542818705rASD0x
289189194ASDS8744
178105417841045784
8456152156181SDSA
31289105205648AWD
04518478415615ASD
0547810544898718AF
056489413216848OP
054894561564ASDW
5648974891AD98156

2/28
3/1
3/1
3/2
3/5
3/11
3/11
3/15
3/16
3/17
3/19

1542202074tWWzv48
14547847586KDDL564

2/26
2/28

4545754784KOHUIOS

2/27

9525156489SFD4545Q
56415615647OJSNDS
84151564SADS8745H
256489156189451516L

2/23
2/26
2/27
2/28

Post Date
Description of Transaction or Credit
Purchases (cont.)
3/1
Store #11
3/2
Store #12
3/3
Store #13
3/6
Store #14
3/12
Store #15
3/12
Store #16
3/16
Store #17
3/17
Store #18
3/17
Store #19
3/18
Store #20
3/20
Store #21
Cash Advances
2/26
Cash Advance
2/28
Cash Advance
Balance Transfers
3/1
Balance transfer
Fees
2/23
Late Fee
2/26
Cash Advance Fee *transaction Fee*
2/27
Balance transfer Fee *transaction Fee*
2/28
Cash Advance Fee *transaction Fee*
TOTAL FEES FOR THIS PERIOD
Interest Charged
Interest Charge on Purchases
Interest Charge on Cash Advances
TOTAL INTEREST FOR THIS PERIOD

Amount
$14.76
$3.76
$13.45
$2.35
$25.00
$7.34
$10.56
$24.50
$8.76
$14.23
$23.76
$121.50
$196.50
$785.00
$35.00
$5.00
$23.55
$5.90
$69.45
$6.31
$4.58
$10.89

2007 Totals Year-to-Date
total fees charged in 2007

$90.14

total interest charged in 2007

$18.27

Interest Charge Calculation
Your Annual Percentage Rate (APR) is the annual interest rate on your account.
Annual Percentage Rate (APR)

Balance Subject to
Interest Rate

Interest Charge

Purchases

14.99% (v)

$512.14

$6.31

Cash Advances

21.99% (v)

$253.50

$4.58

$637.50

$0.00

Type of Balance

Balance transfers

0.00%

(v) = variable rate

Fee-Inclusive APR
the Fee-Inclusive APRs in this table are the APRs that you paid this period when transaction or fixed fees are taken into
account as well as interest.
Type of Balance

Interest Charges

Transaction or
Fixed Fees

Fee-Inclusive APR

Purchases

$6.31

$0.00

14.99%

Cash Advances

$4.58

$10.90

58.42%

Balance transfers

$0.00

$23.55

36.00%

G-18(H) Periodic Statement Form

Page 1 of 2

XXX Bank Credit Card Account Statement
Account Number XXXX XXXX XXXX XXXX
February 21, 2007 to March 22, 2007
Payment Information

Summary of Account Activity
Previous Balance
Payments
Other Credits
Purchases
Balance Transfers
Cash Advances
Past Due Amount
Fees Charged
Interest Charged

$80.52
-$50.00
+$0.00
+$52.13
+$0.00
+$0.00
+$0.00
+$37.00
+$0.00

New Balance

$119.65

Credit limit
Available credit
Statement closing date
Days in billing cycle

$2,000.00
$1,880.35
3/22/2007
30

QUESTIONS?
Call Customer Service
lost or Stolen Credit Card

New Balance

$119.65

Minimum Payment Due

$10.00

Payment Due Date

4/20/07 (before 2:00 pm)

Late Payment Warning: If we do not receive your
minimum payment by the date listed above, you may have
to pay a $35 late fee and your APRs may be increased up
to the Penalty APR of 28.99%.
Notice about Minimum Payments: If you make only the
minimum payment each month, it will take you about 13
months to repay the balance shown on this statement.
Please send billing inquiries and correspondence to:
PO Box XXXX, Anytown, Anystate XXXXX

1-XXX-XXX-XXXX
1-XXX-XXX-XXXX

Notice of Changes to Your Interest Rates

You have triggered the Penalty APR of 28.99%. Effective 5/10/07, we will apply the penalty rate to
all balances on this account. We may keep your APRs at this level indefinitely.

Transactions
Reference Number

Trans Date

854338203FS8OO0z5

2/25

5884186PS0388w6YM
0544400060zlV72Vl
55541860705RDYD0X
554328608008w90M0
054830709lYMRPT4l
564891561545KOSHD
841517877845AKOJIO
895848561561894KOH
1871556189456SAMKl
2564894185189lKDFID
55542818705RASD0X
178105417841045784
8456152156181SDSA

2/22
2/24
2/24
2/24
2/24
2/25
2/25
2/26
2/26
2/27
3/1
3/2
3/5

Post Date
Description of Transaction or Credit
Amount
Payments and Other Credits
2/25
Pymt Thank You
$50.00–
Purchases
2/23
Store #1
$2.05
2/25
Store #2
$2.11
2/25
Store #3
$4.63
2/25
Store #4
$4.95
2/25
Store #5
$7.35
2/26
Store #6
$4.35
2/26
Store #7
$2.35
2/27
Store #8
$7.68
2/27
Store #9
$4.76
2/28
Store #10
$2.87
3/2
Store #11
$3.76
3/6
Store #12
$2.35
3/12
Store #13
$2.92
(transactions continued on next page)

NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION
Page 1 of 2

Please detach this portion and return with your payment to insure proper credit. Retain upper portion for your records.

Please indicate address change and additional
cardholder requests on the reverse side.

Account Number:

XXXX XXXX XXXX XXXX

New Balance

$119.65

Minimum Payment Due

$10.00

Payment Due Date

4/20/07 (before 2:00 pm)

AMOUNT ENCLOSED: $

XXX Bank
P.O. Box XXXX
Anytown, Anystate XXXXX

l l l l ll lll llll ll ll llllll ll llll llll ll llll llll lllll

l l l lll lll lll

ll ll

ll ll l l l ll l lll llll ll ll ll lll llll ll

ll l lllll l lll lll ll l ll llll

XXX Bank Credit Card Account Statement
Account Number XXXX XXXX XXXX XXXX
February 21, 2007 to March 22, 2007

Page 2 of 2

Transactions (cont.)
Reference Number

Trans Date

9525156489SFD4545Q
56415615647OJSNDS

2/23
3/22

Post Date
Description of Transaction or Credit
Fees
2/23
Late Fee
3/22
Minimum Charge *Fixed Fee*
TOTAL FEES FOR THIS PERIOD
Interest Charged
Interest Charge on Purchases
Interest Charge on Cash Advances
TOTAL INTEREST FOR THIS PERIOD

Amount
$35.00
$2.00
$37.00
$0.00
$0.00
$0.00

2007 Totals Year-to-Date
Total fees charged in 2007

$90.14

Total interest charged in 2007

$18.27

Interest Charge Calculation
Your Annual Percentage Rate (APR) is the annual interest rate on your account.
Annual Percentage Rate (APR)

Balance Subject to
Interest Rate

Interest Charge

Purchases

14.99% (v)

$113.80

$0.00

Cash Advances

21.99% (v)

$0.00

$0.00

$0.00

$0.00

Type of Balance

Balance Transfers

0.00%

(v) = Variable Rate

Fee-Inclusive APR
The Fee-Inclusive APRs in this table are the APRs that you paid this period when transaction or fixed fees are taken into
account as well as interest.
Type of Balance

Interest Charges

Transaction or
Fixed Fees

Fee-Inclusive APR

Purchases

$0.00

$2.00

21.09%

Cash Advances

$0.00

$0.00

0.00%

Balance Transfers

$0.00

$0.00

0.00%

G-19 Checks Accessing a Credit Card Sample

Interest and Fee Information
APR for Check
Transactions

1.7% (Intro. APR through your November 2007 billing cycle)

Fee

Either $5 or 3% of the amount of each transfer, whichever is greater.

Grace Period

There is no grace period for transactions you make with these checks; we will begin
charging interest on the transaction date.

After November 2007, you will be charged the APR for Cash Advances, currently
21.99%.

G-20 Change-in-Terms Sample
Important Changes to Your Account Terms
The following is a summary of changes that are being made to your account terms. You have the right to opt out of these
changes. For more detailed information, please refer to the booklet enclosed with this statement. The effective date of
these changes is 5/10/07. Note: The change to your APR for purchases described below wil not go into effect at this time
if you are already being charged a higher Penalty APR on purchases. This change will go into effect when the Penalty APR
no longer applies.

Revised Terms, as of 5/10/07
APR for Purchases
Late Payment Fee

16.99%
$32 if your balance is less than or equal to $1,000;
$39 if your balance is more than $1,000

G-21 Penalty Rate Increase Sample
Notice of Changes to Your Interest Rates

You have triggered the Penalty APR of 28.99%. Effective 5/10/07, we will apply the penalty rate to
all balances on this account. We may keep your APRs at this level indefinitely.