Balance Transfer Request Take control of your finances when you transfer balances to a CUA Give Back Visa® credit card. *Before requesting a balance transfer, please ensure you have an existing CUA credit card with enough available credit to accommodate these transfers. Personal Information Last Name First Name MI Social Security Number Mother's Maiden Name Member Number Last four numbers on your CUA Visa Card Address City State Zip Code Home Phone Work Phone CUA is hereby authorized to pay off the balance(s) due on the following charge account(s) by issuing the check(s) or electronic payment as indicated and adding the balance to my Credit Union of America VISA Card account (may not exceed CUA VISA Card credit limit). Checks will be issued directly to the creditor(s). The credit union is not responsible for payments which are late or lost in the mail. Rates and Terms for Balance Transfers are located here. Credit Card 1 Name on Credit Card Creditor/Company Name Card Number Amount to Pay $ (Balance) Company Payment Address (Found on Statement) City State Zip Code Credit Card 2 Name on Credit Card Creditor/Company Name Card Number Amount to Pay $ (Balance) Company Payment Address (Found on Statement) City State Zip Code Credit Card 3 Name on Credit Card Creditor/Company Name Card Number Amount to Pay $ (Balance) Company Payment Address (Found on Statement) City State Zip Code Credit Card 4 Name on Credit Card Creditor/Company Name Card Number Amount to Pay $ (Balance) Company Payment Address (Found on Statement) City State Zip Code Prove you're not a robot. Refer to VISA Terms and Conditions disclosure and agreement for full details.