PERSONAL CARDS
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American Express


American Express® Rewards Plus Gold Card
IMPORTANT INFORMATION REGARDING YOUR APPLICATION / INITIAL DISCLOSURES
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 Annual Fee  Late Payment Fee
Basic Card: No annual fee for the first year, then $150.
No annual fee for up to five Additional Cards.
$35 for each Additional Card after the first five.		 Varies from state to state, from zero to the greater of $35 or 2.99% of delinquent balance.
All charges made on this Charge Card are due and payable when you receive your billing statement.
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By submitting this application, I ask that a Card account be opened in my name and Card(s) issued as I request, and that you renew and replace them until I cancel. I agree to be bound by the Agreement governing my account. I understand that the agreement governing the account includes an arbitration provision, which impacts my opportunity to have claims related to the account heard in court or resolved by a jury, and to participate in a class action or similar proceeding. I understand that the agreement governing the account also provides, among other things, that the account terms, such as fees, are subject to change. I agree to be liable for all charges to my account, including charges incurred with any Additional Card(s) issued on my account now or in the future.

I understand that I must provide all the information requested in this application and I certify that such information is accurate. I authorize you to verify the information on this application and to receive and exchange information about me including requesting reports from consumer reporting agencies. If I ask whether or not a consumer report was requested, you will tell me, and if you received a report, you will give me the name and address of the agency that furnished it. I authorize you and your affiliates and subsidiaries to contact these sources for information at any time and to use any information obtained about me for marketing and administrative purposes.

Only qualified individuals 18 or over may be approved for the Card.

Additional Cards: I have advised Additional Card applicant(s) that you may obtain, verify, exchange, and use information about them in the same manner as described above, that they may be responsible for payment of their own charges if I fail to pay them, and that their own credit records may be affected by nonpayment of the account. I understand that Additional Card(s) will not be issued to me if I have an unsatisfactory account with American Express or if the Additional Card applicants have ever had an unsatisfactory account with American Express.

I acknowledge that any benefit or service offered with the Card may be modified or terminated at any time.

An applicant if married may apply for a separate account.


Patriot Act Notice: Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account, including your name, address, date of birth and other information that will allow us to verify your identity.

Notice to Married Wisconsin Residents: No provision of any marital property agreement, unilateral agreement, or court decree under Wisconsin's Marital Property Act will adversely affect a creditor's interests unless, prior to the time credit is granted, the creditor is furnished a copy of that agreement or decree, or is given complete information about the agreement or decree.

The American Express Rewards Plus Gold Card is issued by American Express Centurion Bank. All rights reserved. ©2009 American Express Centurion Bank.

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