DEBIT MASTERCARD APPLICATION

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1 DEBIT MASTERCARD APPLICATION Hickory Point Bank s Debit MasterCard - the only card you need Our Debit MasterCard gives you a fast, economical and convenient way to purchase the products and services you need. Using the card is easier than writing a check, safer than carrying cash and as handy as an ATM card. Not a credit card The Hickory Point Bank Debit MasterCard may look like a credit card, but it s not. It is a checking account debit card that you use like a credit card, but you re paying electronically through your Hickory Point Bank checking account. And, the Hickory Point Bank MasterCard is accepted anywhere MasterCard is accepted. Here and there Using the Hickory Point Bank Debit MasterCard lets you avoid the lengthy check approval process and saves you time while you shop. Simply present the debit card to the merchant and sign your sales receipt. You ll get a copy of your signed receipt, and you can view all of your transactions on your monthly checking account statement. Plus you ll have access to the cash in your checking account while traveling away from home. No more searching for identification or carrying cash while you travel. Cash may also be available by visiting a participating bank to obtain a cash advance from your checking account. Daily limits are: $2,000 in merchant transactions and $500 in ATM cash transactions. Of course it s an ATM card too The Hickory Point Bank Debit MasterCard doubles as your ATM card and offers you access to your bank accounts at thousands of ATMs worldwide. Just visit any machine that displays the MasterCard, CIRRUS, MoneyPass or STAR symbol for quick access to cash. We make it easy To receive a Hickory Point Bank Debit MasterCard, please complete and return this application and you ll receive your card in approximately 10 business days upon approval. Hickory Point Bank Debit MasterCard services are available only to Hickory Point Bank checking account holders. To open a Hickory Point Bank checking account, visit any branch or apply online here. Checking Account Number: Depositor s Name: Depositor s Social Security Number: Joint Depositor s Name: Joint Depositor s Social Security Number: Home Phone Number: Daytime Phone Number: Street Address: City: State: Zip Code: Please select card style: Blue Green HSA (1 of 2 pages)

2 To Hickory Point Bank: Please read before signing. I (we) authorize you to make whatever investigative inquiries deemed necessary in connection with this application and to exchange information with others regarding my (our) card transactions. If this application is approved and a Hickory Point Bank MasterCard is issued, the undersigned applicant(s), by signing, using, or permitting another to use the Hickory Point Bank Debit MasterCard agree to be bound by the terms and conditions accompanying the Hickory Point Bank Debit Master- Card and all amendments. The undersigned hereby acknowledges that the signing, using, or permitting another to use the Hickory Point Bank Debit MasterCard represents an acknowledgement of the receipt of the Electronic Funds Transfer (EFT) Agreement and Disclosure and all amendments and further represents the acceptance of the terms and conditions of the Electronic Funds Transfer (EFT) Agreement and Disclosure and all amendments. After I (we) receive my (our) Hickory Point Bank Debit MasterCard, I (we) will need to activate the card by performing a PIN (Personal Identification Number) based transaction. The PIN for the card will be sent to you (us) in a separate mailing, and may arrive prior to the card itself. This code permits use of the card for the purposes of initiating electronic funds transfers to and from account(s) through automated teller machines, point-of-sale terminals and other electronic facilities that may be made available from time to time. I (We) understand that a Hickory Point Bank Debit MasterCard is not a credit card, and that no commitment to extend credit to me (us) will be made by your issuance of the Hickory Point Bank Debit MasterCard (s) requested. Notice: All persons having signature authority on the checking, savings or money market accounts listed on this application must sign. Customer Signature/Date Customer Signature/Date If you would also like your Hickory Point Bank Debit MasterCard to access your savings accounts at more than 285,000 ATMs worldwide, or to access your money market account at Hickory Point Bank owned and operated ATMs, enter the account numbers below: Savings Account Number Money Market Account Number Please print and return your application to any branch or mail your application to: Hickory Point Bank, P.O. Box 2548, Decatur, IL (2 of 2 pages)

3 DEBIT MASTERCARD DISCLOSURE 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 retain this notice for future reference. ATM Transfers STAR and Cirrus Networks types of transfers and frequency, and dollar limitations You may access your account(s) by ATM using your Debit MasterCard and personal identification number in order to: Make deposits to checking or savings account(s) Get cash withdrawals from checking or savings account(s) you may withdraw no more than $500 per day Transfer funds between checking and savings account(s) Get information about the account balance of your checking and/or savings account(s) ATM transactions are limited to 15 per 24-hour period. Some of these services may not be available at all terminals. Types of Point-of-Sale Transactions You may access your checking account(s) to purchase goods (in person or by phone), pay for services (in person or by phone), get cash back from a merchant, if the merchant permits, or from a participating financial institution, and do anything that you can do with a credit card (that a participating merchant will accept with a credit card). Point-of Sale Transactions frequency and dollar limitations Using your card: You may make no more than 15 transactions per 24-hour period You may not exceed $2000 in transactions per day Currency Conversion If you effect a transaction with your Debit MasterCard in a currency other than US dollars, MasterCard International Inc. with convert the charge into a US dollar amount. MasterCard International will use its currency conversion procedure, which is disclosed to institutions that issue MasterCard cards. Currently the conversion rate used by MasterCard International to determine the transaction amount in US dollars for such transactions is generally either a government mandated rate or a wholesale rate determined by Master- Card International for the processing cycle in which the transaction is processed, increased by an adjustment factor established from time to time by MasterCard International. The currency conversion rate used by MasterCard International on the processing date may differ from the rate that would have been used on the purchase date or cardholder statement posting date. Advisory Against Illegal Use You agree not to use your card(s) for illegal gambling or other 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. 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 transfer). DOCUMENTATION Terminal Transfers You may get a receipt at the time you make any transfer to or from your account using one of our automated teller machines or point-of-sale terminals. Periodic Statements You will get a monthly account statement from us for your checking account(s). You will get a monthly account statement from us for your savings account(s), unless there are no transfers in a particular month. In any case, you will get a statement at least quarterly. 1

4 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 ATM 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 problem 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 that 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 beurea or merchant; or 3. In order to comply with government agency or court orders; or as explained in the separate Privacy Disclosure. UNAUTHORIZED TRANSFERS a) Consumer liability Generally, tell us AT ONCE if you believe your card and/or PIN has been lost or stolen. Telephoning is the best way of keeping your possible losses down. You could lose all of the money in your account (plus your maximum overdraft line of credit). If you believe your card and/or PIN has been lost or stolen, and you tell us within 2 business days after you learn of the loss or theft, you can lose no more than $50 if someone used your card and/or PIN without your permission. If you DO NOT tell us within 2 business days after you learn of the loss or theft of your card and/or PIN, and we can prove we could have stopped someone from using your card and/or PIN 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) prevented you from telling us, we may extend the time periods. Additional Limits on Liability for Debit MasterCard when used for point-of-sale transactions You will not be liable for any unauthorized transactions using your Debit MasterCard when used for point-of-sale transactions, if: You can demonstrate that you have exercised reasonable care in safeguarding your card from the risk of loss or theft; You have not reported to us two or more incidents of unauthorized use within the prior twelve-month period; 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 MasterCard 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 limitation on liability does not apply to PIN-based transactions or transactions not processed by MasterCard. b) Contact in event of unauthorized transfer If you believe your card and/or PIN has been lost or stolen or that someone has transferred or may transfer money from your account without your permission, call us at or toll free at or write us at Hickory Point Bank, P.O. Box 2548, Decatur, IL

5 ERROR RESOLUTION NOTICE In case of errors or questions about your electronic transfers, call us at or toll free at or write us at Hickory Point Bank, P.O. Box 2548, Decatur, IL as soon as you can, if you think your statement or receipt is incorrect 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. Tell us the dollar amount of the suspected error; 3. Describe the error or 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. 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 calendar days (90 calendar 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 provisionally 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 you already have an established account with us before this account is opened. We will tell you the results within 3 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. ACCOUNT PROTECTION To protect your account, we monitor ATM and Debit MasterCard transactions for potentially fraudulent activity which may include a sudden change in locale, a string of costly purchases or any pattern associated with new fraud trends. If we suspect fraudulent use, we will call you to validate the legitimacy of your transactions. SAFE AND SECURE When you receive your Debit MasterCard, you ll be assigned a personal identification number (PIN) to provide secure access to your account(s). As an added safeguard, we also provide a cap on your liability if your card is lost or stolen. For online purchase protection, we offer the latest technology to help guard against unauthorized use of your Debit MasterCard through the MasterCard SecureCode. Every time you pay online at a participating merchant with your Debit MasterCard, you ll be automatically prompted to enter your own private SecureCode - just like entering a PIN at an ATM. Visit and click on the MasterCard SecureCode link to enroll your card. You may also enroll at participating online merchants, where you will be prompted to create your own SecureCode prior to check out. MasterCard is a registered trademark of MasterCard International Inc. 3

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