Balance Transfer Application

Upon approval of this application, Commerce Bank will issue a check in the amount(s) indicated to pay off the balance of the credit card account(s) you have indicated, to the extent allowed by your available credit limit. The bank will mail the check(s) to the institution(s) indicated.

Applicant General Information (Required Fields are marked with *)

First * MI Last *

Name

Address Line 1 *

Address Line 2

City *

State * Zip * -

Home Phone Number *

( ) -

Business Phone Number

( ) -

(mm/dd/yyyy) ### ## ####

Date of Birth *

Social Security Number * - -

Mother's Maiden Name *

Commerce Credit Card Information

Commerce Credit Card Account Number *

Expiration Date (Month/yy) *

Promotional Code

¹ Balance Transfer Details: Please list Balance Transfer requests in order of priority. Balance Transfers must be from an existing credit card with another institution. You understand to close an account with another credit card company, you must notify the issuer directly. The total amount of your Balance Transfer request(s), including all applicable fees, cannot exceed the value of your available credit limit, established by Commerce Bank at account opening. Commerce Bank will evaluate your Balance Transfer request(s) in the order you provide them. If you make requests for Balance Transfers that exceed your credit limit, Commerce Bank may, at its discretion, decline the request or send less than the full amount requested to your designated payee. The Balance Transfer or Convenience Check fee is either $10.00 or 5.00% of the amount of each Balance Transfer or Convenience Check, whichever is greater. To assure your non-Commerce Bank accounts remain in good standing, please continue to pay those accounts as required. Upon approval, we will notify you regarding the Balance Transfer check (s) mailed on your behalf. It can take up to 30 days for a Balance Transfer to post on the other account. See the Cardholder Agreement for more details.