Fillable Visa Credit Card Authorized User Request Form (Georgia's Own Credit Union)

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Visa Credit Card Authorized User Request Form (Georgia's Own Credit Union)

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The Visa Credit Card Authorized User Request Form (Georgia's Own Credit Union) form is 1 page long and contains:

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  • 11 other fields

Country of origin: US
File type: PDF

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Cardholder Information:
Name
Member Number
Visa Card Number
Authorized User Information:
Name
Social Security Number
Date of Birth
Relationship to Cardholder
Please include a photocopy of the Authorized User’s driver’s license for signature identification.
T
he selection below reflects the wishes of the Cardholder and Authorized User as it pertains to credit bureau reporting
of the Authorized User’s access to this revolving credit:
Report to Credit Bureaus Do Not Report to Credit Bureaus
I
authorize Georgia’s Own Credit Union to add the above-named individual as an authorized user on my named credit
card account and to have that card reported through the credit bureau as selected above.
X X
Cardholder’s Signature (Date) Authorized User’s Signature (Date)
On
ce we have received the necessary information and processed the request, a card in the Authorized
User’s name will be mailed to the Cardholder’s address within 7 to 10 business days.
Authorized users are unable to make the following requests/inquires:
Change Account Address
Request a limit increase
Negotiate interest rates
If you should have any questions, please contact us at 404-874-1166 or through secure web message
online at www.georgiasown.org
.
GO3468 12/2017
www. georgiasown.org
Visa® Credit Card Authorized
User Request Form
FORM INSTRUCTONS: 3) Submit All Documents to:
1) Complete all applicable fields Georgia’s Own Visa Department
2) Print, sign, and date PO BOX 105205 Atlanta GA 30348
Or by FAX 404-575-1837
Terminate an existing card agreement
Add or remove authorized users
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Visa Credit Card Authorized User Request Form (Georgia's Own Credit Union)

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Completed 23 December 2020

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