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Wards Charg-all Security Plan (CSP)

Anew and meaningful social advance In consumer credit. You will

be

protected against-

1.

Loss of employment income. If you, the account

holder, lose your job income, Wards CSP will make

your monthly Charg-all payments for up to

9

months because of involuntary job loss, strike or

illness.

2.

Damage or destruction of your Wards merchan–

dise. Purchases charged to your Charg-all account

which are taken by burglary, damaged or destroyed

by fire, flood, collision, and other defined perils, will

be repaired or replaced by CSP.

In Minnesota and Wisconsin, CSP coverage for property loss, as

described in paragraph 2 above, is not authorized. In lieu thereof,

coverage for loss of employment income, by making your monthly

payments, will continue for the entire period of unemployment, up to

the total balance on your account at the time of loss of employment

income. CSP is authorized in Iowa, Michigan, Minnesota, Montana,

3. Misuse of your lost or stolen Charg-all card. CSP

will pay any and all unauthorized charges for which

you are liable. Under Federal law your liability

could be up to

$50.

(By

law, not available to Wisc.

residents.)

4.

Death or dismemberment. If you or your spouse

should die or suffer dismemberment from any

cause before you, the account holder, reach age

66-or after you are 66 in case of accidental death

or dismemberment-your account balance is paid

in full up to

$5,000

per account.

North Dakota, South Dakota and Wisconsin as of the printing of this

catalog. To obtain the insurance protection applicable to your state of

residence, read and sign the Insurance Agreement below. Once you re–

ceive your individual insurance certificates, you'll still have

10

days in

which to review them. If you want to change your mind, you're free to

do so.

Bring or send to Wards, or

CALL

Words Charg-all

Appllcatlon-1tor credit

applications only)

TOLL-FREE

(800) 231-5776.

X81

(source

Code 821)

In submitting this application I authorize you to investigate my credit record and if an account is established for me, furnish information concerning my credit file

to consumer reporting agencies and other proper recipients.

IAGE

IHOME PHONE (Area Code)

INO.OF

I

soc.

SEC. NO.

DEPENDENT

TELLUS

1

CHILOREN

ABOUT

IOWN O

RENT O

BOARD ~tMOUNTOF

YOURSELF

FIRST

LAST

MONTHLY RENT OR

NAME

INITIAL

NAME

MOBILE HOME 0 PARENTS 0 OTHER 0 MORTGAGE PAYMENTS

PRESENT

YEARS AT

ADDRESS

CITY

STATE

ZIP CODE

THIS ADDRESS

PREVIOUS

YEARS AT

ADDRESS

CITY

STATE

ZIP CODE

THIS ADDRESS

OCCUPATION

I

PRESENT

ITYPEOF

YEARS WITH

OR RANK

EMPLOYER

BUSINESS

EMPLOYER

EMPLOYER'S

ADDRESS

CITY

STATE

ZIP CODE

PHONE

PREVIOUS

YEARS

I

Information about alimony, child support

I

APPLICANT'S TOTAL GROSS

EMPLOYER

AT

or maintenance payments need not be disclosed.

INCOME PER MO. (all sources)$

ARE YOU A CITIZEN

0

YES

IF NOT, ALIEN REGISTRATION

#1·551

NUMBE:"--------------------------------

OF THE U.S.A.?

O NO

1-151

NUMBE"

DO

YOU NOW HAVE

PERSONAL O GROUP O

'EDUCATION

O HIGH

O SOME

O COLLEGE

I

MODEL YEAR(S)

2119

LIFE INSURANCE?

NONE O

COMPLETED

SCHOOL

COLLEGE GRAD

OFAUTO(S)

.!l.!L

Information about

CHECKING O

CHECKING O

TELL

US

r,ol!r Bank. Credit

INSTITUTION NAME AND BRANCH

SAVINGS O

INSTITUTION NAME AND BRANCH

SAVINGS O

n1on or

LOAN O

LOAN O

ABOUTYOUR2

Savings

&

Loan

CREDIT

ACCT. NUMBER

ACCT. NUMBER

REFERENCES

USTCREDIT

FIRM NAME

LOCATION

ACCT. NO.

EXACT NAME ON ACCT.

MONTHLY PAYMENT PRESENT BALANCE

REFERENCES

Incl. bank and travel cerds.

fin1nc1 companies, charge

1ccts.. oil companies, etc.

~::::!.""'

111111

~

PREVIOUS WARDS ACCOUNTI YES

0

NO

0

IF YES, GIVE ACCT. NO. AND/OR LOCATION:

INFORMA..=3

SPOUSE

(optional)

Provide this information only

n

your spouse is authorized

ta

uso this account or you

ore

relying on your spouse's income

IS

a

b11is for payment.

Do you 1uthoriz1 your spouse to use this account? YES 0 NO 0

SPOUSE'S

YRS. AT

NAME •

OCCUPATION

EMPLOYER

THISJOB

EMPLOYER'S

ADDRESS

CITY

STATE

ZIP

BANK

GROSS

INCOME

PERMO. S

CHECKING O

SAVINGS O

LOAN O

~NATURE

4

AUTHORIZED

USERS

In addition to my spouae (if any) I authorize the foUowing to use my account.

NAME

ADDRESS

In submitting this application I authorize you to investigate my credit record and, nan

account is established for me. furnish information concerning my credit file to consum–

er reporting agencies and other proper recipients.

SIGNATUREX

DATE

NAME

ADDRESS

SIGNATUREX

DATE

Ihave read the Charg-alf agreement

set

out on pg.

320

and agree to the terms and conditions thereof.

APPLICANT'S DRIVER'S LICENSENUMBE"---------

lnltial her

if

you do not wish

to receive any of the special merchandise and service offers described in paragraph

10

on pg.

320.

WARDS

CHARG·ALL

5

INSURANCE

AGREEMENT

I desire Wards Group Charg-all Security Plan Insurance

(CSP) in those states authorized as described above,

and in accordance with the terms stated in the Certifi–

cates of Insurance to be sent me which are issued by

Montgomery Ward Life Insurance Co. for life benefits

and Central National Insurance Co. of Omaha for other benefits. The cost of CSP

is .0050 of my previous balance each month. Insurance is involuntary. If avail–

able elsewhere, it may be obtained through a person of my own choosing and I

may cancel at any time.

APPLICANT'S SIGNATURE

SPOUSE'S SIGNATURE

AGE

DATE

s

WARDS

321