A creditor who distributes its own credit card application within the state of Minnesota shall complete and file the credit card disclosure report form contained in this part.
A creditor shall file a credit card disclosure report form with the Department of Management and Budget on December 31 of each year beginning in 1992. The information provided must be current as of January 1 of the following year.
The following form must be used in conjunction with this chapter:
DEPARTMENT OF MANAGEMENT AND BUDGET
TREASURY DIVISION
CREDIT CARD DESK
303 ADMINISTRATION BUILDING
SAINT PAUL, MINNESOTA 55155
MINNESOTA CREDIT CARD DISCLOSURE REPORTFORM
Minnesota Statutes, section 325G.415, requires any creditor who distributes its own credit card application in Minnesota to annually file certain information regarding this credit with the commissioner of management and budget. The Minnesota Credit Card Disclosure Report Form must be filed annually with the Department of Management and Budget no later than December 31. The information contained in the report must be current as of January 1 of the following year.
INSTRUCTIONS
A. | You are not required to file this form if you merely distribute credit card applications on behalf of a creditor other than yourself. |
B. | You may, but are not required to, provide the commissioner of management and budget with the name and address of any creditor for whom you distribute credit card applications. Please use the space provided on the next line. Use additional sheets if necessary. |
_____ | |
C. | Use one form for each credit card offered. |
D. | Give specific dollar amounts or percentage rates charged to Minnesotans. Do not use ranges. |
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1. | _____ | ||
Name of Creditor | |||
2. | _____ | ||
Street and/or P.O. Address | |||
3. | _____ | _____ | _____ |
City | State | Zip Code | |
4. | _____ | _____ | |
Name of Person Preparing this Form | Phone | ||
5. | _____ | ||
Name of Credit Card | |||
6. | _____ | Amount of any membership, participation, or similar fee that may be imposed as a condition of the issuance or renewal of the credit card, expressed as an annual amount. | |
7. | _____ | Charges for exceeding credit limits. | |
8. | _____ | Amount of late payment fees. | |
9. | Credit Purchases | Cash Advances | |
_____ | _____ | Annual Percentage Rate (A.P.R.) charged to Minnesotans. | |
_____ | _____ | Is the A.P.R. a variable rate? | |
_____ | _____ | If variable, identify the index used, if any. | |
_____ | _____ | If variable, what is the "spread" from the index? | |
_____ | _____ | Amount of any minimum, fixed, transaction, activity, or similar charge. | |
_____ | _____ | The date or occasion upon which the finance charge, if any, begins to accrue on the transaction; that is, the grace period. (For example, "25 days after statement closing date"). | |
_____ | _____ | Is the entire credit card balance due and payable upon receipt of a periodic statement of charges? | |
_____ | _____ | Amount of any fees charged other than those listed above. | |
10. | Set forth below any other information which you believe would clarify the information provided above: (Use additional sheets if necessary) | ||
_____ | |||
_____ | |||
_____ | |||
_____ | |||
11. | Please attach a list of organizations through which the creditor offers credit cards in Minnesota. | ||
_____ | _____ | ||
Signature and Title of Creditor's Representative | Date | ||
MAIL FORM TO: | Department of Management and Budget Treasury Division ATTN: Credit Card Desk 303 Administration Building St. Paul, Minnesota 55155 |
Minn. R. agency 197, ch. 9700, pt. 9700.0200
Statutory Authority: MS s 325G.415