Personal Debit Card Application Form

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C US Bank Debit Card

C US Bank Cadet Debit Card

Applicant

Name:

Social Security Number:

Date of Birth:

Street Address:

Phone Number:

City:

State:

Zip:

Accounts to be attached to SHAZAM Check Card

Checking Account #;

New Account?

Yes

Savings Account #:

Signatures

By clicking here, I certify that the above information is complete and true, and is provided to C US Bank to request the issuance of a SHAZAM Chek card.

By clicking here, I agree to the terms, conditions,and any applicable fees as explained in the Electronic Funds Transfer disclosure.

Disclosure PRINTABLE DISCLOSURE

IMPORTANT ACCOUNT INFORMATION FOR OUR CUSTOMERS

from
C US Bank
111 N Elm St
PO Box 57
Cresco, IA  52136
(563)547-2040

ELECTRONIC FUND TRANSFERS  
YOUR RIGHTS AND RESPONSIBILITIES

Indicated below are types of Electronic Fund Transfers we are capable of handling, some of which may not apply to your account.  Please read this disclosure carefully because it tells you your rights and obligations for the transactions listed.  You should keep this notice for future reference.

Electronic Fund Transfers Initiated By Third Parties - You may authorize a third party to initiate electronic fund transfers between your account and the third party's account.  These transfers to make or receive payment may be one-time occurrences or may recur as directed by you.  These transfers may use the Automated Clearing House (ACH) or other payments network.  Your authorization to the third party to make these transfers can occur in a number of ways.  For example, your authorization to convert a check to an electronic fund transfer or to electronically pay a returned check charge can occur when a merchant provides you with notice and you go forward with the transaction (typically, at the point of purchase, a merchant will post a sign and print the notice on a receipt). In all cases, these third party transfers will require you to provide the third party with your account number and financial institution information.  This information can be found on your check as well as on a deposit or withdrawal slip.  Thus, you should only provide your financial institution and account information (whether over the phone, the Internet, or via some other method) to trusted third parties whom you have authorized to initiate these electronic fund transfers.  Examples of these transfers include, but are not limited to:

• Preauthorized credits - You may make arrangements for certain direct deposits to be accepted into your checking or savings.

• Preauthorized payments - You may make arrangements to pay certain recurring bills from your checking or savings.

• Electronic check conversion - You may authorize a merchant or other payee to make a one-time electronic payment from your checking account using information from your check to pay for purchases or pay bills.

• Electronic returned check charge - You may authorize a merchant or other payee to initiate an electronic funds transfer to collect a charge in the event a check is returned for insufficient funds.

CUSB DIRECT PHONE transactions - types of transactions - You may access your account by telephone using your account number(s), personal identification number (PIN), social security number and touch tone phone to: 
• transfer funds from checking to checking or savings
• transfer funds from savings to checking or savings
• make payments from checking or savings to loan account (s) with us
• get balance information about checking, savings, certificate of deposit or line of credit
• get withdrawal history about checking or savings
• get deposit history about checking, savings or certificate of deposit
• get transaction history about checking or savings

You may access your account for telephone transactions at the following number(s) and during the following hours:
• (563)547-2872 (24 hours a day)
• (888)225-2872 (24 hours a day)

Shazam ATM Card transactions - types of transactions - You may access your account(s) by ATM using your Shazam ATM Card and your personal identification number (PIN) to:
• deposit funds to checking or savings account(s)
• withdraw cash from checking or savings account(s)
• transfer funds from savings to checking account(s)
• transfer funds from checking to savings account(s)
• get balance information about checking or savings
•You may not exceed your daily dollar limit in transactions per day: Unmanned (ATM) limit $320 Point of Sale limit $1,500
Some of these services may not be available at all terminals.   
ShazamChek Card point-of-sale transactions - types of transactions - You may access your checking account(s) by ShazamChek Card to do transactions that participating merchants will accept, including: 
• purchase goods (in person, by phone, or online),  pay for services (in person, by phone, or online), get cash from a merchant, if merchant permits, or from a participating financial institution and do anything that a participating merchant will accept.

Foreign Currency Conversion and Cross-Border Transactions - If you effect a transaction with your ShazamChek Card in a currency other than U.S. dollars, MasterCard will convert the charge into U.S. dollar amount. The MasterCard currency conversion procedure includes use of either a government - mandated exchange rate, or a wholesale exchange rate selected by MasterCard.  The exchange rate MasterCard uses will be a rate in effect on the day the transaction is processed.  This rate may differ from the rate in effect on the date of purchase or the date the transaction was posted to your account.  
MasterCard charges us a Currency Conversion Assessment of 20 basis points (.2% of the transaction) for performing the currency conversion.  In addition, MasterCard charges us Issuer Cross-Border Assessment of 80 basis points (.8% of the transaction) on all cross-border transactions regardless of whether there is a currency conversion.  As a result, we will charge you a Cross-Border Transaction fee of 1% on all cross-border transactions regardless of whether there is a currency conversion.  A cross-border transaction is a transaction processed through Global Clearing Management System or the MasterCard Debit Switch in which the country of the merchant is different than the country of the cardholder.

Advisory Against Illegal Use.  You agree not to use your card(s) for illegal gambling or illegal purpose.  Display of a payment card logo by, for example, an online merchant does not necessarily mean that transactions are lawful in all jurisdictions in which the cardholder may be located.

MasterCard SecureCode.  When using your ShazamChek card to purchase goods or services over the internet, you may come across merchants that use the MasterCard SecureCode program.  MasterCard SecureCode is a system designed to reduce disputes and fraudulent activity by ensuring that the person using your ShazamChek card to purchase goods and services online is in fact you.  The objective of the program is to improve the security of internet transactions as well as cardholder and merchant confidence in internet purchases. 
We participate in the MasterCard SecureCode program and are proud to offer you this service.  Prior to using the MasterCard SecureCode program you must register for the program.  You may sign up for the MasterCard SecureCode by going to www.shazam.net/securecode/ and following the simple online instructions.

CUSB On-Line Banking - types of transfers - You may access your accounts by computer at www.cusb.com and using your personal identification number (PIN) and log-in ID to: 
• transfer funds from checking to checking or savings
• transfer funds from savings to checking or savings
• transfer funds from loans to checking or savings
• make payments from checking to loan accounts with us
• make payments from checking to third party with BillPay
• make payments from savings to loan accounts with us
• get balance information about checking, savings, certificate of deposit or loan account(s)
• get withdrawal history about checking, savings, or certificate of deposit 
• get deposit history about checking, savings, certificate of deposit account(s)
• get transaction history about checking, savings, certificate of deposit or loan account(s)
Limits and fees - Please refer to our fee disclosure for information about fees and limitations that may apply to these electronic fund transfers. 
ATM Operator/Network Fees - When you use an ATM not owned by us, you may be charged a fee by the ATM operator or any network used (and you may be charged a fee for a balance inquiry even if you do not complete a fund transfer). 
Limitations on frequency of transfers - In addition to those limitations on transfers elsewhere described, if any, the following limitations apply to your Savings and Optimum Return Account account(s): 
Transfers from a savings account to another account or to third parties by preauthorized, automatic, telephone, or computer transfer are limited to six per month.
Transfers from an Optimum Return Account to another account or to third parties by preauthorized, automatic, telephone, or computer transfer or by check or similar order to third parties are limited to six per statement cycle.   
Documentation  
Terminal transfers - You can get a receipt at the time you make a transfer to or from your account using an automated teller machine or point-of-sale terminal.  However, you may not get a receipt if the amount of the transfer is $15 or less. 
Preauthorized credits - If you have arranged to have direct deposits made to your account at least once every 60 days from the same person or company:  
• the person or company making the deposit will tell you every time they send us the money.
• you can call us at (563)547-2040 to find out whether or not the deposit has been made.
Periodic statements - You will get a monthly account statement from us for all your accounts with electronic funds transfers. 
 Preauthorized Payments  
Right to stop payment and procedure for doing so - If you have told us in advance to make regular payments out of your account, you can stop any of these payments.  Here is how: 
Call or write us at the telephone number or address listed in this disclosure in time for us to receive your request three business days or more before the payment is scheduled to be made.  If you call, we may also require you to put your request in writing and get it to us within 14 days after you call. 
Notice of varying amounts - If these regular payments may vary in amount, the person you are going to pay will tell you, 10 days before each payment, when it will be made and how much it will be.  (You may choose instead to get this notice only when the payment would differ by more than a certain amount from the previous payment, or when the amount would fall outside certain limits that you set.) 
Liability for failure to stop payment of preauthorized transfer - If you order us to stop one of these payments three business days or more before the transfer is scheduled, and we do not do so, we will be liable for your losses or damages.

Financial Institution's Liability
Liability for failure to make transfers - If we do not complete a transfer to or from your account on time or in the correct amount according to our agreement with you, we will be liable for your losses or damages. However, there are some exceptions. We will not be liable, for instance:
(1) If, through no fault of ours, you do not have enough money in your account to make the transfer.
(2) If you have an overdraft line and the transfer would go over the credit limit.
(3) If the automated teller machine where you are making the transfer does not have enough cash.
(4) If the terminal or system was not working properly and you knew about the breakdown when you started the transfer.
(5) If circumstances beyond our control (such as fire or flood) prevent the transfer, despite reasonable precautions that we have taken.
(6) There may be other exceptions stated in our agreement with you.

Confidentiality 
We will disclose information to third parties about your account or the transfers you make:  
(1) where it is necessary for completing transfers; or
(2) in order to verify the existence and condition of your account for a third party, such as a credit bureau or merchant; or
(3) in order to comply with government agency or court orders; or
(4) as described in our privacy policy disclosure, provided separately.

Unauthorized Transfers  
(a) Consumer liability.  (1) Generally, tell us AT ONCE if you believe your card and/or code has been lost or stolen. Telephoning is the best way of keeping your possible losses down. You could lose all the money in your account (plus your maximum overdraft line of credit). If you tell us within two business days, you can lose no more than $50 if someone used your card and/or code without your permission. (If you believe your card and/or code has been lost or stolen, and you tell us within two business days after you learn of the loss or theft, you can lose no more than $50 if someone used your card and/or code without your permission.)

If you do NOT tell us within two business days after you learn of the loss or theft of your card and/or code, and we can prove we could have stopped someone from using your card and/or code without your permission if you had told us, you could lose as much as $500.

Also, if your statement shows transfers that you did not make, tell us at once. If you do not tell us within 60 days after the statement was mailed to you, you may not get back any money you lost after the 60 days if we can prove that we could have stopped someone from taking the money if you had told us in time.

If a good reason (such as a long trip or a hospital stay) kept you from telling us, we will extend the time period.

(2) Additional Limits on Liability for SHAZAMChek card, when used for point-of-sale transactions. You will not be liable for any unauthorized transactions using your SHAZAMChek card, when used for point-of-sale transactions, if: (i) you can demonstrate that you have exercised reasonable care in safeguarding your card from the risk of loss or theft, (ii) you have not reported to us two or more incidents of unauthorized use within the prior twelve-month period, and (iii) your account is in good standing. If any of these conditions are not met, your liability is the lesser of $50 or the amount of money, property, labor, or services obtained by the unauthorized use before notification to us. 'Unauthorized use' means the use of your debit card by a person, other than you, who does not have actual, implied, or apparent authority for such use, and from which you receive no benefit.This additional limit on liability does not apply to ATM transactions or to transactions using your personal identification number which are not processed by MASTERCARD.
(b) Contact in event of unauthorized transfer.  If you believe your card and/or code has been lost or stolen, call or write us at the telephone number or address listed in this disclosure. You should also call the number or write to the address listed in this disclosure if you believe a transfer has been made using the information from your check without your permission.

Error Resolution Notice 
In case of errors or questions about your electronic transfers, call or write us at the telephone number or address listed in this disclosure, as soon as you can, if you think your statement or receipt is wrong or if you need more information about a transfer listed on the statement or receipt. We must hear from you no later than 60 days after we sent the FIRST statement on which the problem or error appeared.

(1) Tell us your name and account number (if any).

(2) Describe the error or the transfer you are unsure about, and explain as clearly as you can why you believe it is an error or why you need more information.

(3) Tell us the dollar amount of the suspected error.

If you tell us orally, we may require that you send us your complaint or question in writing within 10 business days.

We will determine whether an error occurred within 10 business days (20 business days if the transfer involved a new account) after we hear from you and will correct any error promptly. If we need more time, however, we may take up to 45 days (90 days if the transfer involved a new account, a point-of-sale transaction, or a foreign-initiated transfer) to investigate your complaint or question. If we decide to do this, we will credit your account within 10 business days (20 business days if the transfer involved a new account) for the amount you think is in error, so that you will have the use of the money during the time it takes us to complete our investigation. If we ask you to put your complaint or question in writing and we do not receive it within 10 business days, we may not credit your account. Your account is considered a new account for the first 30 days after the first deposit is made, unless each of you has an established account with us before the account is opened.

We will tell you the results within three business days after completing our investigation. If we decide that there was no error, we will send you a written explanation.

You may ask for copies of the documents that we used in our investigation.
If you have inquiries regarding your account, please contact us at:

C US Bank
DATA PROCESSING
111 N ELM ST
PO BOX 57
CRESCO, IA  52136
BUSINESS DAYS: Monday, Tuesday, Wednesday, Thursday and Friday
Holidays are not included. 
PHONE: (563)547-2090 or (800)397-9964

Notice Of ATM/Night Deposit Facility User Precautions
As with all financial transactions, please exercise discretion when using an automated teller machine (ATM) or night deposit facility.  For your own safety, be careful.  The following suggestions may be helpful.
1.  Prepare for your transactions at home (for instance, by filling out a deposit slip) to minimize your time at the ATM or night deposit facility.
2.  Mark each transaction in your account record, but not while at the ATM or night deposit facility.  Always save your ATM receipts.  Don't leave them at the ATM or night deposit facility because they may contain important account information.
3.  Compare your records with the account statements you receive.
4.  Don't lend your ATM card to anyone.
5.  Remember, do not leave your card at the ATM.  Do not leave any documents at a night deposit facility.
6.  Protect the secrecy of your Personal Identification Number (PIN).  Protect your ATM card as though it were cash.  Don't tell anyone your PIN.  Don't give anyone information regarding your ATM card or PIN over the telephone.  Never enter your PIN in any ATM that does not look genuine, has been modified, has a suspicious device attached, or is operating in a suspicious manner.  Don't write your PIN where it can be discovered.  For example, don't keep a note of your PIN in your wallet or purse.
7.  Prevent others from seeing you enter your PIN by using your body to shield their view.
8.  If you lose your ATM card or if it is stolen, promptly notify us.  You should consult the other disclosures you have received about electronic fund transfers for additional information about what to do if your card is lost or stolen.
9.  When you make a transaction, be aware of your surroundings.  Look out for suspicious activity near the ATM or night deposit facility, particularly if it is after sunset.  At night, be sure that the facility (including the parking area and walkways) is well lighted.  Consider having someone accompany you when you use the facility, especially after sunset.  If you observe any problem, go to another ATM or night deposit facility.
10. Don't accept assistance from anyone you don't know when using an ATM or night deposit facility.
11. If you notice anything suspicious or if any other problem arises after you have begun an ATM transaction, you may want to cancel the transaction, pocket your card and leave.  You might consider using another ATM or coming back later.
12. Don't display your cash; pocket it as soon as the ATM transaction is completed and count the cash later when you are in the safety of your own car, home, or other secure surrounding.
13. At a drive-up facility, make sure all the car doors are locked and all of the windows are rolled up, except the driver's window.  Keep the engine running and remain alert to your surroundings.
14. We want the ATM and night deposit facility to be safe and convenient for you.  Therefore, please tell us if you know of any problem with a facility.  For instance, let us know if a light is not working or there is any damage to a facility.  Please report any suspicious activity or crimes to both the operator of the facility and the local law enforcement officials immediately.

MORE DETAILED INFORMATION IS AVAILABLE ON REQUEST

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Personal Debit Card Application Form

Applicant

Accounts to be attached to SHAZAM Check Card

Signatures

Disclosure PRINTABLE DISCLOSURE