Credit Card Balance Transfer Request Form

NOTE: Existing Allegacy balances not eligible for balance transfers. Balance transfer rates outside of promotion period will be reflected as cash advances and the current rate will apply.

*Member Number:
*Member Name:
*Allegacy Visa Account Number:
*Address:
*City, State Zip	,
*Home Phone
*E-mail

Balance Transfer 1
*Creditor Name
*Address:
*City, State Zip	,
*Account Type (i.e.: Discover, American Express)
*Account #
*Verify Account Number
*Amount

Balance Transfer 2
Creditor Name
Address:
City, State Zip	,
Account Type (i.e.: Discover, American Express)
Account #
Verify Account Number
Amount