Travel Request

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Note: This form is used to inform Allegacy when you are traveling so your card is not blocked due to suspicious activity. If there are additional family members traveling with you and they also have an ATM, Check or Credit Card they will need to complete their own form. Forms submitted after 4:00pm (EST) will be processed the following business day. If traveling at this time please call the contact center 336-774-3400. Monday - Thursday: 7:30am - 5pm Friday: 7:30am - 6pm (EST)

*Member Number:

*Primary Member Name (First M. Last)

*Contact Phone Number (Cell)

*eMail address

*ATM, Check or Credit Card Number(s)

*Departure Date

*Return Date

Destination(s): If traveling to Europe please list countries that will be visited.

Comments

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