Credit Union of America - Balance Transfer Request

Limited time offer applies to balances transfers from non-CUA cards to CUA’s VISA Platinum Give Back Credit card completed January 15, 2019 - February 28, 2019. Promotional Annual Percentage Rate (APR) valid through December 2019 statement cycle date and includes a 1% balance transfer fee (min $10). After December 21, 2019, your APR will be 11.90%-20.00%. APR varies with the market based on the Prime Rate.

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) 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/Payee Name

Account Number	Amount to Pay $

Payment Address

City	State	Zip Code

Credit Card 2
Name on Credit Card	Creditor/Payee Name

Account Number	Amount to Pay $

Payment Address

City	State	Zip Code

Credit Card 3
Name on Credit Card	Creditor/Payee Name

Account Number	Amount to Pay $

Payment Address

City	State	Zip Code

Credit Card 4
Name on Credit Card	Creditor/Payee Name

Account Number	Amount to Pay $

Payment Address

City	State	Zip Code

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