MilesAway Express Application

Please fill in the information below. Information marked with a * is required to submit your request. When finished, click the "Submit Request" button at the bottom of the page.

Please tell us about yourself.
  • (as xxx-xx-xxxx)
  • (as mm/dd/yyyy)
  • (This Program is not available in Puerto Rico, Guam or Virgin Islands.)
 
  • (as xxx-xxx-xxxx)
Please tell us about your practice.
 
  • (as xxx-xxx-xxxx)
  • (as xxx-xxx-xxxx)
  •  
  • Your e-mail address will never be sold. It will be used to send you important notices.
years
years
Please provide us with some financial information.
$
Please show us how you would like your card imprinted.
Name and title (designation) and/or clinic name as you would like it imprinted on your card. Your full name and practice name cannot exceed 21 characters per line, including spaces. Please spell your last name completely.
  • Doctor's Name, e.g., John Henry Smith
  • (Optional) Practice Name, e.g., Smith Clinic
Authorization and Disclosure

By submitting this request, I certify that I have read, met and agreed to all of the terms, conditions and disclosures below.

IMPORTANT INFORMATION REGARDING YOUR APPLICATION

MilesAway MasterCard Terms, Conditions and Disclosures

Annual Fee

NONE

Periodic Rate of Finance Charge

The Monthly Periodic Rate of Finance Charge on portions of your Account will be determined in accordance with a variable rate plan. Introductory Rates may be used from time to time. Purchases on your Account are charged a variable ANNUAL PERCENTAGE RATE (“Variable APR”). The “Periodic Rate” for any given billing cycle shall be calculated in accordance with the following formula: (Annual Percentage Rate/365) x (Number of days in billing cycle) = Periodic Rate. For complete details on the Periodic Rate of Finance Charge click here.

Grace Period on Purchases

25 calendar days.

Minimum Finance Charge

$.50

Transaction Fees

Cash Advance - 3% of the transaction amount (minimum $10).
Over the Credit Limit Fee - $25.
Dishonored Payment Fee - $25 (except in Maryland).
Late Payment Fee - $25.
Alternative Payment Method - $10 for any payment you make via the Automated Response Unit. $15 fee for phone payment with a customer service representative.
Balance Transfer Fee - 3% of the amount of the Balance Transfer (minimum $10, maximum $75).

Note: These terms and conditions are current as of September 2013. If you have any questions, please call 1-800-503-0954, option 2 for assistance.

By signing the application, I/we:(1) request that NCMIC Finance Corporation (herein “NCMIC”), the card issuer, establish a MilesAway business credit card account for me and/or my company and issue one or more cards to be used in connection with the account; (2) understand this application is given for the purpose of obtaining credit and is subject to approval; (3) authorize NCMIC or its designees to investigate my personal and/or business creditworthiness by obtaining reports from credit reporting agencies and other information and credit records and to share such information regarding the account with credit reporting agencies, other creditors of my business, and third parties that NCMIC reasonably believes are conducting credit inquiries in accordance with applicable law; (4) authorize NCMIC to order a credit report in connection with the administration, review, or collection of the account and in connection with offering additional products and services to me; (5) authorize past and present lenders, lessors, landlords, and other creditors to provide NCMIC and its designees with any and all information that will assist in the credit inquiry; and (6) certify that all information provided in this application is true and correct.

I/we agree that, if a credit card account is opened in response to this application: (1) the account and the card(s) shall be governed by the terms and conditions of the Cardholder Agreement provided to me when the card(s) are issued, as it may be amended from time to time; (2) I’m/we’re personally liable for all charges, advances, and fees made or incurred under the account by my company or anyone authorized or permitted by my company to use the account and/or the card(s); (3) the account shall be used only for business or commercial purposes; (4) the credit line and the terms of my account will be based on a review of the information provided in this application, the current credit report, and any other information bearing on creditworthiness; and (5) any dispute arising under or related to the account or the card(s) shall be adjudicated in the federal or state court located in Polk County, Iowa.

Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has, in good faith, exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with the law concerning this credit is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580. If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact: The MilesAway Program, 14001 University Avenue, Clive, Iowa 50325-8258 within 60 days from the date you are notified of our decision. We will send you a written statement of the reasons for the denial within 30 days of receiving your request for the statement.

Important Information About Procedures for Opening a New 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, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

Click here to print the terms, conditions and disclaimers

* I have read the Authorization and Disclosure and: