CarCareONESM
Credit Card Application   

 
A credit service of GE Money Bank ("GEMB").
 
Please take a moment to tell us about yourself by completing the application below. Once you have completed the application:
    Click the submit button and the application will be processed immediately.
    You may receive a response to your application in as little as 30 seconds!
    For your protection, your application information will be encrypted.
OR    
    Print this application, complete it, and mail or fax it to:
    GE Card Services
    Attention: Application Processing OH3-4250
    P.O. Box 8817
    Dayton, Ohio 45482-9940
     
    Fax to 1-800-333-3196

 

 

APPLICANT INFORMATION

  

 

 
Please use only characters A to Z , a to z and 0 to 9 when completing your application except for your e-mail address where you may also use @ .(period) - _ / \ |.
 

 

 
NOTICE TO MARRIED WISCONSIN RESIDENTS: No provision of a marital property
agreement, a unilateral statement under Sec. 766.59 Wis. Statutes, or a court decree under
Sec. 766.70 Wis. Statutes, adversely affects the interest of creditor unless the creditor,
prior to the time the credit is granted, is furnished a the copy of the agreement, statement
or decree or has actual knowledge of the adverse provision when the obligation to the
creditor is incurred. If you are married, you acknowledge that this account is being
opened in the interest of your marriage or family. If you are applying for individual credit
or joint credit with someone who is not your spouse, combine your and your spouseýs
financial information on the application form. If your spouse also is a Wisconsin resident,
we are required by law to obtain the name and address of your spouse.

 

  Initial Purchase amount if Known :   $ .00

 

 
  First Name:
  Middle Initial:
  Last Name:
  Suffix:
  Mother’s Maiden Name:

 

RM/00

 
  Date of birth (MM/DD/YYYY):  /   / 
  Social Security number: - -
  Home phone number: - -
  (with area code)
  Business Phone Number: - -
  (with area code)


  Present address:
  Apartment number:
  City:
  State:
  Zip code:
  Country:
  E-mail Address (Optional):
By providing my email address, I consent to receive e-mail communications about my account and authorize you to provide my e-mail address to each dealer that accepts the CarCareONESM credit card.

 

 
  Driver’s License (or State Issued Id) Information :
  Number (dashes allowed) :
  State Issued :
  Expiration Date (MM/YY) :
 / 

 

 
  Alimony, child support or separate maintenance income need
   not be revealed unless to be relied upon as a basis for
  repayment.
  Annual Net Income  $ .00
 (From All Sources) (Whole dollars, do not use , or .)
 Housing Information:  

 

 

 
  Name of nearest relative not     
  living with  you:  
  First Name:
  Middle Initial:
  Last Name:
  Relative’s phone number: - -
 
(with area code)

 


CO-APPLICANT INFORMATION

Complete only if applying jointly for credit - Co-Applicant will also receive a "CarCareONESM Credit Card" upon approval.

  First Name:
  Middle Initial:                        
  Last Name:
  Suffix:

  Date of birth (MM/DD/YYYY):  /   / 
  Social Security number: - -
  Home phone number: - -
  (with area code)
  Business Phone Number: - -
  (with area code)

 

 
  Present address:
  Apartment number:
  City:
  State:
  Zip code:
  Country:
  E-mail Address (Optional):
By providing my email address, I consent to receive e-mail communications about my account and authorize you to provide my e-mail address to each dealer that accepts the CarCareONESM credit card.

 

 
  Driver’s License (or State Issued Id) Information :
  Number (dashes allowed):
  State Issued :
  Expiration Date  (MM/YY) :  / 

 

 
  Alimony, child support or separate maintenance income need
  not be revealed unless to be relied upon as a basis for
  repayment.
  Annual Net Income:  $ .00
  (From All Sources) (Whole dollars, do not use , or .)
  Housing Information:

 

By signing this application, I ask the GE Money Bank ("you") issue me a CarCareONESM credit card. I am providing this information both to you and to dealer that accept the CarCareONESM credit card. I also authorize and direct you to furnish information about me (including whether this application is approved or declined) and, if it is approved, information about my Account, to dealer that accept the CarCareONESM Credit Card (and their affiliates) for use in connection with the CarCareONESM Credit Card program, including to create and update their customer records for me, to assist them in better serving me, and to provide me with notices of special promotions, catalogs and tailored offerings. I affirm that the Information I have submitted is complete and truthful and that my Account will be used only for personal, family and household purposes. I Authorize you to make inquiries you consider necessary (including requesting reports from consumer reporting agencies and other sources) in evaluating my application, and subsequently, for purposes of reviewing, maintaining or collecting my Account. Upon my request, you will advise me of the name and address of each consumer reporting agency from which you obtained a report. I also understand that the CarCareONESM credit card agreement (the "Agreement") will govern my Account, the terms of which are hereby incorporated by reference into and made a part of this application, and that these TERMS INCLUDE AN ARBITRATION PROVISION WHICH MAY SUBSTANTIALLY LIMIT MY RIGHTS. My signature on this application represents my signature on the Agreement. I acknowledge that under the Agreement, I grant you a security interest in goods purchased on the Account, as permitted by law. I understand that there is no agreement between us until you approve my application, and that if approved, our Agreement will be deemed to have been made in Utah. I understand that I may apply for my own Account regardless of my marital status. After the credit approval and subject to the governing credit agreement, each applicant may use this Account and will each be liable for all credit extended under this Account to any Applicant or Authorized user.

Federal law requires us to obtain, verify, and record information that identifies you when you open an account.  We will use your name, address, date of birth, and other information for this purpose.


f you are submitting your application by mail, fax or in person, please sign and date your application below.
 

 

 

Applicant Signature

Date

 

 

Co-Applicant Signature

Date

(if applicable)

    
 

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