3.99% on Balance Transfers Through Jan. 1st, 2009!

Full Name
 First Community Credit Card Account #
---

1) Exact Amt. To Transfer
 Name of Card Issuer (i.e. bank name)
Issuer (Bank) Phone Number
 Address to send payoff
City
 St
 Zip Code
Card Number to be paid off
--- 		Loan Number


2) Exact Amt. To Transfer
 Name of Card Issuer (i.e. bank name)
Issuer (Bank) Phone Number
 Address to send payoff
City
 St
 Zip Code
Card Number to be paid off
--- 		Loan Number


3) Exact Amt. To Transfer
 Name of Card Issuer (i.e. bank name)
Issuer (Bank) Phone Number
 Address to send payoff
City
 St
 Zip Code
Card Number to be paid off
--- 		Loan Number

By signing below, I authorize you to bill my First Community credit card in the amount(s)shown above. I understand that my balance transfer request(s) are processed as Cash Advances according to the Terms & Conditions of First Community's Credit Card agreement and are subject to credit availability and my qualification as a member in good standing. I understand that Finance Charges will be assessed from the date each balance transfer is posted as a Cash Advance to my First Community credit card account. I understand that you will advise me if you are unable to process my request for any reason. I understand that you will process balance transfers in any order you choose, subject to my available credit line. In addition, you will not be responsible for any charges billed to me for the accounts indicated. I understand that I should continue to make my monthly payments to each creditor until the balance transfer appears as a credit on the account(s). I understand if I transfer an amount for a transaction I dispute, I may lose my rights against the other creditor. I understand that balance transfers must not include requests to pay down or pay off any of my loan or other credit card accounts with First Community Credit Union.

Member's Signature:                                                                                         Date:

Member's Signature:                                                                                         Date:

Drop this off at your local branch or mail to:

First Community Credit Union
P.O. Box 1030
Chesterfield, MO 63006
Attn: Credit Card Dept.