Visa Debit Card Application

The Visa Debit Card is used in conjunction with your checking account. It is accepted anywhere in the United States that displays the Visa logo. It can also be used to withdraw funds from ATM’s. To apply for a Visa Debit Card complete the requested information listed below. Once completed print and sign the form. You can either fax or mail the completed application to the number/address below.

Credit Union Account Number: *

Name: *

Address: *

City: *

State: *

ZIP: *

Home Phone:

Work Phone:

Date of Birth: *

Mother's Maiden Name: *

Joint Owner Information

Name:

Address:

City:

State:

ZIP:

Home Phone:

Work Phone:

Date of Birth:

Please read and sign below

You agree and understand that if approved, you are contractually liable according to the applicable terms of the Check Card Agreement and Disclosure. You acknowledge receiving a copy of the Agreement and promise to pay all amounts charged to your account according to its terms. If this is a joint application, you agree that such liability is joint and several. Use of your Paducah Federal Visa Debit Card is subject to all PFCU rules and regulations also governing your accounts as described in the Terms and Conditions of your Deposit Account, Electronic Funds Transfer and Check Hold Policy disclosures. You authorize the credit union to obtain consumer credit reports about you.

___________________________________

Signature of Primary owner

___________________________________

Signature of Joint owner

PFCU Use Only

___ Approved ___ Disapproved Date _________

Loan Officer _______________________________

Date Card(s) ordered ________________________

Primary Card Number _______________________

Joint Card Number __________________________

Paducah Federal Credit Union

Attn: Debit Card Application
PO Box 426
Paducah KY 42002-0426

Fax 270-443-6148

You may also complete application at any of our five locations. Upon approval your card and pin # will be mailed to you in 7 to 10 business days. For security purposes they will be mailed separately. You will need both the card and pin # when calling to activate the card.

Paducah Federal Credit Union is federally insured by the National Credit Union Administration. We do business in accordance with the Federal Fair Housing Law and the Equal Credit Opportunity Act. Membership is limited. NCUA now insures member accounts up to $250,000 - ncua.gov