Your personal information
Optional
Optional
Optional

MM

DD

YYYY

IMPORTANT INFORMATION ABOUT OPENING AN ACCOUNT:

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth or other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.

CA Residents: If you are married, you may apply for a separate account. NY, RI and VT Residents: We may order credit reports in connection with processing applications and any update, renewal or extension of credit. Upon request, we will tell you the name and address of any consumer-reporting agency that furnished a report on you. You consent to the obtaining of such reports by signing or otherwise submitting an application or solicitation.OH Residents: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy 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. WI Residents: No provision of a marital property agreement, unilateral statement under Section 766.59 or court decree under Section 766.70 adversely affects the interest of Comenity Bank, unless the Bank, prior to the time credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the Bank is incurred.

Annual income
$  
Eg.40000
Alimony, child support or separate maintenance income need not be included if you do not wish to have it considered as a basis for repaying this obligation. Married WI Residents only: If you are applying for an individual account and your spouse also is a WI resident, combine your and your spouse's financial information.
Address information
Optional

To open an account, you must have a street, rural route, or APO/FPO mailing address. We do not accept PO Box mailing addresses.

Contact information
() -
() - Optional

By providing your contact information, including any cellular or other phone numbers, you agree to be contacted regarding any of your Comenity Bank or Comenity Capital Bank accounts via calls to cell phones, text messages or telephone calls, including the use of artificial or pre-recorded message calls, as well as calls made via automatic telephone dialing systems or via e-mail.