Visa  MasterCard  Other Credit Card(s)
Credit Card Account Number
Issuer's Name		Issuer's Complete Address
City		State   Zip
Balance to pay-off   Close? Yes No

Visa  MasterCard  Other Credit Card(s)
Credit Card Account Number
Issuer's Name		Issuer's Complete Address
City		State   Zip
Balance to pay-off   Close? Yes No

Visa  MasterCard  Other Credit Card(s)
Credit Card Account Number
Issuer's Name		Issuer's Complete Address
City		State   Zip
Balance to pay-off   Close? Yes No

Visa  MasterCard  Other Credit Card(s)
Credit Card Account Number
Issuer's Name		Issuer's Complete Address
City		State   Zip
Balance to pay-off   Close? Yes No

Additional Comments

I/We authorize PFFCU to pay-off and/or close (based on my individual selections) the accounts listed above with proceeds from my/our Police and Fire Federal Credit Union VISA Classic/ VISA Platinum account. A balance transfer is considered a cash advance and not a purchase. There is no grace period, and interest begins to accrue on the balance as soon as it is transferred to your PFFCU VISA Card. I/We understand that any finance charges and outstanding balances incurred after these pay-offs will be my/our responsibility. It will also be my/our responsibility to destroy all cards issued for the above listed accounts.