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For each Credit Card you wish to transfer, please provide:

✓ Name of Creditor(s)

✓ Your most recent credit card statement(s)

✓ Name(s) as they appear on the card(s)

✓ Account Number(s)

✓ Payment Mailing Address(es)

✓ Transfer Payment Amount(s) (including all interest owed)

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Balance Transfer Request

By signing below, I grant Blackhawk Community Credit Union permission to make a balance transfer from my Visa® account. I understand checks will be made payable to the designated creditor(s) and mailed by BHCCU. Based on when your payment is received, some remaining interest may still be due. I assume responsibility for any unpaid balance(s).

Credit Card #1: ___________________________Amount $ _____________________________

Credit Card #2: ___________________________Amount $ _____________________________

Credit Card #3: ___________________________Amount $ _____________________________

BHCCU Visa® Account #: ___________________

_______________________________________________________

Member Name (Please Print)

____________________________________ Date: ___________________

Member Signature

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BALANCE TRANSFER CHECKLIST

✓ Balance Consolidation Rate is the same as purchases.

✓ Estimate that the payoffs may take up to 21 days to be posted. The amount of time can vary with each credit card processor. Please monitor your credit card balances and make sure to make your minimum payment until your balances are paid in full.

✓ To ensure your payment is processed as quickly as possible be sure you check your current statement for the exact name and account number that appears on your statement. Mismatches can cause delays in posting.

✓ If you charged anything since your last statement or your balance consolidation check is not processed before your credit card cycle date, you may still have a final payment to your existing cards. To protect your credit history, continue to make payments until the balance is zero.

✓ Completing a balance transfer does not change you liability on cards you have open. If your payoff amount did not cover your entire balance on the card you intended to pay off you will need to continue to make payments on this card until paid in full or complete another balance transfer.

✓ Note that transferring your balance to the BHCCU card will not close the accounts you paid. If your intent is to close those accounts you may need to provide a written request to that company. Please be aware that closing credit lines may impact your credit score. If you have questions please ask your BHCCU loan officer for assistance.

For office use only:

Forward to CardServices Department

Acct # __________________________

Appl. ID_________________________

Doc/Loan Type MC/Visa

Date_____________________________

TLR#_________________________

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