Lowe’s Consumer Credit Card Application This form is designed to be printed and then filled out by hand. To shorten response time, please carefully and completely answer all questions and then sign and date the application. Once complete, you may mail it to: Lowe's P.O. Box 103080 Roswell, GA 30076 Applicant(s) please read the following ­ (1) Married applicants may apply for separate Accounts. After credit approval each Applicant shall have the right to use this Account to the extent of any credit limit set by the creditor and each Applicant will be liable either individually or together as we shall determine for all amounts of credit extended under this Account to any Applicant or Authorized User. (2) Alimony, child support or separate maintenance income need not be disclosed unless relied upon for credit. (3) For Married Wisconsin Residents Only: If you are applying for an individual Account combine your financial information below. 1. APPLICANT: Please tell us about yourself First Name: ___________________________________ Middle Initial: __ Last Name: ___________________________________ Jr, Sr, III, IV: _____ Home Address (Steet Name and Number Required): __________________________________________ Mailing Address (If different from Home Address-P.O.Box, etc.): __________________________________________ City: _____________________________________ State: ____________ Zip: ____________ Country: ____ Previous Address "Please provide previous address if you have been at your current address for less than one year" Previous Address: __________________________________________ Previous City: _____________________________________ Previous State: ____________ Previous Zip: ____________ Birthdate: ____________________ Social Security Number: ____________________ Home Phone: ____________________ Business Phone: ____________________ Name of Nearest Relative: ______________________________ Telephone Number of Nearest Relative: ____________________ Annual Income From All Sources: $____________________ E-Mail Address: (Optional)  __________________________________________________ (By providing my e-mail address, I consent to receive e-mail communications about my account and authorize you to provide my e-mail address to Lowe's.) 2. Additional Authorized User Authorized User: First Name: _________________________ Middle Init.: ____ Last Name: _________________________ Annual Income From All Sources $: ____________________ Social Security Number: ____________________ Relationship With Authorized User: Spouse Other STATE NOTICES: State law requires us to give you the following notices: OHIO RESIDENTS:THE OHIO LAWS AGAINST DISCRIMINATION REQUIRE THAT ALL CREDITORS MAKE CREDIT EQUALLY AVAILABLE TO ALL CREDIT WORTHY CUSTOMERS, AND THAT CREDIT REPORTING AGENCIES MAINTAIN SEPARATE CREDIT HISTORIES ON EACH INDIVIDUAL UPON REQUEST. THE OHIO CIVIL RIGHTS COMMISSION ADMINISTERS COMPLIANCE WITH THIS LAW. WISCONSIN RESIDENTS: No provision of a marital property agreement, a unilateral statement under Sec. 766.59, Wisc. Stats., or a court decree under Sec. 766.70 Wisc. Stats., adversely affects the interests of the creditor unless the creditor, prior to the time credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse obligation when the obligation to the creditor is incurred. Wisconsin law requires that we ask married residents of Wisconsin who are applying for individual credit to provide us with their spouses name and address. Please provide this information to us on or with this application. We are required to ask married residents of Wisconsin who have applied for individual credit to give us the following information: Spouse Information First Name: _____________  Middle Initial: __   Last Name: ______________ Address: _______________________________________________________ City: _________________   State: ____   Zip (Postal Code): __________ By signing this application, I ask that GE Money Bank ("you") issue me a LOWE'S credit card. 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 LOWE'S agreement (the "Agreement") seen previously to this application 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. By signing this application I agree to be bound by the terms of the attached Lowe's Credit Card Agreement, Form No. C822(4/01)3024-I [92488], which are incorporated by reference in and made a part of this Application. 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 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. NOTICE TO APPLICANT(S): (A) DO NOT SIGN BEFORE YOU READ THE PREVIOUSLY SHOWN AGREEMENT OR IF THE AGREEMENT CONTAINS ANY BLANK SPACES. (B) YOU ARE ENTITLED TO A COMPLETELY FILLED IN COPY OF THE AGREEMENT. KEEP A COPY OF THE AGREEMENT TO PROTECT YOUR LEGAL RIGHTS. (C) YOU MAY AT ANY TIME PAY OFF THE FULL UNPAID BALANCE UNDER THE AGREEMENT WITHOUT INCURRING ANY ADDITIONAL CHARGE. To find out about changes in the terms and conditions of the agreement, write to us at P.O. Box 103047, Roswell, GA 30076. If you prefer, you may apply at the Lowe's store nearest you. To find the store near you visit our on-line store locator, or call 1-800-44LOWES Applicant's Signature: ____________________________________ Date: __________ Signing this application indicates your acceptance of the Terms and Conditions shown previously. Accountgard Insurance Enrollment Form   Protect Your Account With Optional Credit Insurance.   By electing optional ACCOUNTGARD® insurance, I acknowledge that: I DO NOT NEED TO PURCHASE THIS INSURANCE TO GET CREDIT and I can get similar coverage from any insurer I choose. ACCOUNTGARD includes credit life, disability, involuntary unemployment and/or leave of absence, to the extent available in my state as described in the Summary of Insurance Coverages.* I have read and I meet the age and employment eligibility requirements shown in the Summary of Insurance Coverages.* Monthly premium charges are based on the account balance and the rate shown. I will receive notice of any rate increase. I may cancel at any time.       *Please see below. First Name __________________  Middle Initial____  Last Name______________________    Date of Birth (MM/DD/YYYY) ___/___/_____   Account Number_______________________    Mailing Address ________________________________________________________ City __________________   State__________________   Zip_____________    YES ____________________________    ___/___/____     ___/___/____                                                        Signature                        Date of Birth           Date    If you wish to obtain one or more of the coverages separately, check the box and an application will be sent to you. (99). To enroll in VA or WI  check the box and an application will be sent to you (99). Accountgard is not available in Alabama and not all coverages are available in every state. Coverage is not available in WV stores. Insurance Codes: NC (01); AK, ID, IN, LA, MI, MN, NE, NM, NY, OR, SC, TX, VT (71); NH (76); VA, WI (99); All others (21)     FOR OFFICE USE ONLY Credit Line                                                     Account Number                                              Date                                                                         822-__ __ __ __ __ __ __ __ __ __ Owner's License (State and Number)                               Employee ID                      Application Code                                                                                                                                                   C822-2200 Home | Store Locator | Credit Card