Credit Card Application

Important Disclosures

Interest Rates / Charges

APR* for Purchases (*Annual Percentage Rate)

Gold Card or Purchasing Card   Prime + 8.70%

The APR for the Gold cards will vary with the market based on the Prime Rate.

APR for Balance Transfers

Gold Card  or Purchasing Card  Prime + 8.70%

The APR for the Gold cards will vary with the market based on the Prime Rate.

APR for Cash Advances

Gold Card  or Purchasing Card  Prime + 8.70%

The APR for the Gold cards will vary with the market based on the Prime Rate.

How to avoid paying interest on purchases

Your due date is at least 25 days after the close of each billing cycle. We will not charge you any interest on purchases if you pay your entire balance by the due date each month.

Minimum interest charge

If you are charged interest, the charge will be no less than $1.00.

Credit card tips from the Consumer Financial Protection Bureau

To learn more about factors to consider when applying for or using a credit card, visit the website of the Consumer Financial Protection Bureau at


Annual Fee


Gold Card or Purchasing Card 

Transaction Fees

Balance Transfer

$10 or 5% of the amount of each transfer will apply, whichever is greater.

Cash Advance

2% of the amount advanced

Foreign Transaction

2% of each transaction in U.S. dollars

Penalty Fees

Late Payment

5% of the unpaid portion of the Minimum Payment or $20.00, whichever is greater

Over-the-Credit Limit

Up to $20.00

Returned Payment


How your balance is calculated: We use a method called “average daily balance (including new purchases).” See your agreement for more details.

Billing Rights: Information on your rights to dispute transactions and how to exercise those rights is provided in your account agreement.

*Variable Rate Information: The Prime Rate used to determine your APR is a variable rate and is the highest (U.S.) Prime Rate published in The Wall Street Journal on the last day of the quarter. Prime Rate changes will then take effect on the first day of the next billing cycle.​

This application takes on average 5 minutes to complete. If necessary, you can save your progress and complete this application at another time without losing your information. After you submit the completed application, it will be processed and you will then be contacted by BSV with the status of your application.

What type of Credit are you applying for?

Business Credit - Relying on Business Financial Statements

Primary - Personal Information

Previous Address

Contact Information

Secondary - Personal Information

Previous Address

Contact Information


Relative Contact Information

Credit Information

Credit Information

Credit Information
*If this is a joint application, please combine financial amounts when applicable.*



Company Information

Principals, Owners & Guarantors of Company

Financial Information

Issue Purchasing Cards to the Following People

The entity named above (Company), requests that The Bank of Southside Virginia, hereafter referred to as BSV, establish a Purchasing Card account in the name of the Company, and that BSV Purchasing Cards be issued to those persons named above, and otherwise directed in writing by the Company from time to time. The Company certifies that the information in this application, and any other documents submitted in connection with the application, is true and correct. The Company authorizes BSV to verify the information and obtain further information concerning the credit standing of the business, its representatives, and to exchange credit information with others. The Company understands that if this application is accepted, card(s) will be issued and credit will be extended by BSV, 17208 Halligan Park Rd, Carson, Virginia 23830. The Company agrees to provide additional information upon request. The Company certifies that such account(s) opened in pursuant to this application shall be used solely for business or commercial purposes, and agrees that unless otherwise directed by the Company in writing, all monthly statements and other notices regarding the account(s) shall be mailed to the Company at the address shown above. Statement balances are due in full within 25 days of this statement date. Any person signing below is authorized to enter into the Agreement on behalf of such business. The Applicant requests that BSV Purchasing Card(s) be issued (as set forth in this application).

Sharing information with Affiliates: Applicable law permits us to share information with third parties about our credit and account history with you. Applicable law also permits us to share additional information about you and your accounts with companies related to BSV by common ownership or control ("affiliates"). We provide this additional information to our affiliates so that you may receive special offers and promotions from our affiliates. You may request that we not furnish additional information (other than credit and account history) to our affiliates by writing to BSV Bankcard Dept., 17208 Halligan Park Rd, Carson, Virginia 23830. Please be aware that processing of such a request does take time. Please also be aware that state and federal laws impose certain mandatory disclosures of customer information by financial institutions. We must company with laws that require mandatory production or disclosures.

Changes to the BSV Purchasing Card account to include reporting, card additions, deletions and address changes are to be authorized by the following company representative(s). Failure to complete this portion assumes the above individuals are the only representatives authorized.

I/we certify that the foregoing information has been supplied truthfully, accurately and voluntarily, and authorize The Bank of Southside Virginia (BANK) to investigate my/our employment, credit worthiness, credit history and financial responsibility through employer(s) or credit bureau(s) or by any other reasonable means, including direct contact with past and present employer(s) and creditors.  I/we authorize banks and financial institutions to give information to the Bank and authorize the Bank to retain this application as its property.  I/we agree to abide by The Bank of Southside Virginia VISA/MasterCard rules, regulations and operating procedures currently in place and as amended in the future, including the obligation to pay an annual fee, if such fee is applicable to this account.  I/we agree that in the event of default of this obligation, all collection efforts, including attorneys' fees and court costs, will be borne by the applicant(s). This card may only be used for legal purposes.