"Travel Card Program Individual Account Application - Visa Business Travel Account" - Kansas

Travel Card Program Individual Account Application - Visa Business Travel Account is a legal document that was released by the Kansas Department of Administration - a government authority operating within Kansas.

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  • Released on March 1, 2013;
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S
K
TATE OF
ANSAS
T
C
P
Individual Account Application
RAVEL
ARD
ROGRAM
Visa Business Travel Account
Important: Cardholder is liable to pay UMB for the amounts charged on the Travel Card
Send
APPLICANT INFORMATION
Applicant Name
Email Address
(first, middle, last)
Social Security
Date of Birth
Home Address
Number
Home
City/State/Zip
Telephone Number (
)
Employer /Agency/Department Name
Position/Title
Agency #
Years There
Gross
Business
Annual Income
Telephone Number (
)
OTHER INFORMATION
Other Sources of Income
Alimony, child support or separate
Maintenance need not be revealed if you do
not wish to have it considered as a basis for
repaying this obligation.
BILLING ADDRESS IF
OTHER THAN LISTED
ABOVE
Estimated monthly spending
A Kansas Business Travel Card account may be terminated at anytime by UMB, Kansas Division of
$
Purchases, or the agency
_______________________________________________________________
AUTHORIZED APPROVAL
APPLICATION AND AGREEMENT
I
Applicant applies to UMB Bank, n.a., Kansas City, Missouri, or its successors or assigns (“Issuer”) for an account as indicated above. If this application is accepted
and credit card(s) issued, those signing above will be deemed to be in agreement with the terms and conditions accompanying the card(s). The Applicant in signing
this form, certifies the information given herein to be true and correct and agrees to pay all charges on such account when due. The Applicant authorizes the Issuer to
obtain and verify from time to time, credit, employment, and other information relating to the undersigned and to answer questions about the Issuer’s credit experience
with Applicant. The Applicant acknowledges and agrees that such information may be used to establish, administer or collect the account requested by the
undersigned for any legitimate purpose relating to the account. The Applicant understands that the Issuer will retain the application whether or not it is approved.
Because this account is offered in conjunction with the applicant's employer State of Kansas Business Travel Card Program, certain information about you and
your use of the account will be supplied to your employer and authorized representatives for administrative purposes. By signing below, you consent to Issuer sharing
information you provide on your application and information about your account with your employer and its' representatives for administrative purposes.
Applicant agrees that unless they write to UMB Bank, n.a. at 928 Grand Boulevard, Suite 501, Kansas City, Missouri 64106,and request that information
not be shared by UMB, n.a. and its affiliates may share information about the Applicant or the account for administrative purposes.
I have read the entire application, agree to its terms, and certify the information is correct.
X
APPLICANT’S SIGNATURE
DATE
Send Completed Applications to:
State of Kansas Business Travel Card Coordinator, Procurement and Contracts 800 SW Jackson, Suite 600 Topeka, KS 66612-1216
03/2013
S
K
TATE OF
ANSAS
T
C
P
Individual Account Application
RAVEL
ARD
ROGRAM
Visa Business Travel Account
Important: Cardholder is liable to pay UMB for the amounts charged on the Travel Card
Send
APPLICANT INFORMATION
Applicant Name
Email Address
(first, middle, last)
Social Security
Date of Birth
Home Address
Number
Home
City/State/Zip
Telephone Number (
)
Employer /Agency/Department Name
Position/Title
Agency #
Years There
Gross
Business
Annual Income
Telephone Number (
)
OTHER INFORMATION
Other Sources of Income
Alimony, child support or separate
Maintenance need not be revealed if you do
not wish to have it considered as a basis for
repaying this obligation.
BILLING ADDRESS IF
OTHER THAN LISTED
ABOVE
Estimated monthly spending
A Kansas Business Travel Card account may be terminated at anytime by UMB, Kansas Division of
$
Purchases, or the agency
_______________________________________________________________
AUTHORIZED APPROVAL
APPLICATION AND AGREEMENT
I
Applicant applies to UMB Bank, n.a., Kansas City, Missouri, or its successors or assigns (“Issuer”) for an account as indicated above. If this application is accepted
and credit card(s) issued, those signing above will be deemed to be in agreement with the terms and conditions accompanying the card(s). The Applicant in signing
this form, certifies the information given herein to be true and correct and agrees to pay all charges on such account when due. The Applicant authorizes the Issuer to
obtain and verify from time to time, credit, employment, and other information relating to the undersigned and to answer questions about the Issuer’s credit experience
with Applicant. The Applicant acknowledges and agrees that such information may be used to establish, administer or collect the account requested by the
undersigned for any legitimate purpose relating to the account. The Applicant understands that the Issuer will retain the application whether or not it is approved.
Because this account is offered in conjunction with the applicant's employer State of Kansas Business Travel Card Program, certain information about you and
your use of the account will be supplied to your employer and authorized representatives for administrative purposes. By signing below, you consent to Issuer sharing
information you provide on your application and information about your account with your employer and its' representatives for administrative purposes.
Applicant agrees that unless they write to UMB Bank, n.a. at 928 Grand Boulevard, Suite 501, Kansas City, Missouri 64106,and request that information
not be shared by UMB, n.a. and its affiliates may share information about the Applicant or the account for administrative purposes.
I have read the entire application, agree to its terms, and certify the information is correct.
X
APPLICANT’S SIGNATURE
DATE
Send Completed Applications to:
State of Kansas Business Travel Card Coordinator, Procurement and Contracts 800 SW Jackson, Suite 600 Topeka, KS 66612-1216
03/2013
S
K
TATE OF
ANSAS
T
C
P
Individual Account Application
RAVEL
ARD
ROGRAM
Visa Business Travel Account
Important: Cardholder is liable to pay UMB for the amounts charged on the Travel Card
Send
DISCLOSURE INFORMATION
ANNUAL PERCENTAGE RATE FOR PURCHASES
13.25%
Variable;8.0% + Prime, which currently equals
.
VARIABLE RATE INFORMATION
Your Annual Percentage Rate (“APR”) may vary monthly. It is determined by adding a “Margin” to the
th
The Wall Street Journal”
highest “Prime Rate” reported in the “Money Rates” section of
on the 15
day of each January, March, May, July, September, and November
.
GRACE PERIOD FOR REPAYMENT OF BALANCES FOR PURCHASES
You have not less than 45 days to repay the entire balance before a Finance Charge will be imposed,
if full payment of both the prior balance and the current balance shown on your Current and Previous
Monthly Statements are received within 45 days after the Statement Closing Dates for such
statements. The entire balance due shown on each Monthly Statement must be paid in full each
month.
METHOD FOR COMPUTING THE BALANCE FOR PURCHASES
Two-cycle average daily balance (including new purchases).
ANNUAL FEE
There is no annual fee for this account.
MINIMUM FINANCE CHARGE
Fifty cents ($.50) for any Billing Period in which a Finance Charge is due.
OTHER FEES
Late Fee:
None
Cash Advance Fee: 3% of cash advance ($10 minimum, no maximum)
IMPORTANT: The information about the costs of the cards described above is accurate as of August 1st, 2012 , the date this
document was published and made available as a downloadable file. This information may have changed after that date. To find out
what may have changed, write to us at UMB Bank, n.a. at 928 Grand Boulevard, Suite 501, Kansas City, Missouri 64106 or email us at our
www.umb.com
commercialcard website at
.
Send Completed Applications to:
State of Kansas Business Travel Card Coordinator, Procurement and Contracts 800 SW Jackson, Suite 600 Topeka, KS 66612-1216
03/2013
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