Balance Transfer Authorization Form

Credit Card Balance Transfer Authorization

After the form is submitted, you will be contacted by a member of our Card Department for confirmation of your transaction(s). Click Submit at the conclusion of this form to securely send to our Card Department.
Primary Member*

First NameLast Name
USEFCU Account Number*
USEFCU Credit Card Number*
Address of Applicant*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail of Applicant
example@example.com
Home Phone Number of Applicant
Mobile Phone Number of Applicant
Signature*

Clear
Your authorized signature confirms your acknowledgment of the balance transfer fee of 3% that will be assessed to your account on completed balance transfers. Sign using your finger (smartphone) or mouse (desktop).
Date*

MonthDayYear
Date

Balance Transfer Information

Please provide the following information from the issuing bank/institution that you are transferring funds from.
Name of Issuing Bank/Institution*
Payment Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Number*
Exact Amount ($) to Transfer*

Balance Transfer Information (cont.)

Complete the following page(s) for any additional institutions you wish to transfer funds from. If you do not have any additional institutions to add, select "Next".
Name of Issuing Bank/Institution
Payment Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Number
Exact Amount ($) to Transfer

Balance Transfer Information (cont.)

Complete the following page(s) for any additional institutions you wish to transfer funds from. If you do not have any additional institutions to add, select "Next".
Name of Issuing Bank/Institution
Payment Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Number
Exact Amount ($) to Transfer

Balance Transfer Information (cont.)

Complete the following page(s) for any additional institutions you wish to transfer funds from. If you do not have any additional institutions to add, select "Next".
Name of Issuing Bank/Institution
Payment Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Number
Exact Amount ($) to Transfer

Form Submission

You are one step away from ridding yourself of high-interest debt! If you provided your email address, an electronic copy of this form will be sent to you. Congratulations!
*Balance transfer amounts are limited to the available funds of your approved credit limit amount. Transfers are considered cash advances. Therefore, finance charges will begin to accrue immediately on the transaction date. Transferred amounts cannot be from another USEFCU Visa card or loan account. Please continue making payments on your other credit card account(s) until the balance transfer is confirmed on your other institution’s account statement. **Your authorized signature confirms your acknowledgment of the balance transfer fee of 3% that will be assessed to your account on completed balance transfers.
Should be Empty:

Credit Card Balance Transfer Authorization