Visa Automatic Payment Service Agreement Form - U.s. Postal Service Federal Credit Union


VISA Automatic Payment Service Agreement
By signing this agreement, you are authorizing the U. S. Postal Service Federal Credit Union (Credit Union) to make automatic monthly
withdrawals from your checking/savings account(s) at another financial institution or USPS FCU to satisfy or partially satisfy the balance owed
on your Credit Union VISA credit card account. The amount to be withdrawn from your account will be determined by your selection of one of
the three options presented below. The automatic payment will be credited to your VISA account on the statement due date. This amount will
be withdrawn from your savings or checking account with the Credit Union or other financial institution within three (3) business days after your
VISA account has been credited. You will be notified of the payment amount via a line item message on your VISA account statement that
reads, “Automatic Payment - Thank You”, along with a message that appears above the “Transactions” summary section to inform you of the
next auto payment credit date. It is understood that the automatic withdrawals will continue until the Credit Union is notified in writing by you
that the transfers are to cease. In order to cancel the automatic withdrawal, a written notification must be received at least five business days prior
to the next statement closing date, otherwise it will take effect the following month and any payment made by the Credit Union in the current
month is the responsibility of the account holder and not the Credit Union.
Cardholder Automatic Payment Authorization
***************Please Attach a Voided Check***************
Primary Cardholder Name (Please Print) _________________________________________________________________________
Secondary Cardholder Name ____________________________________________________________________________________________
Street Address_____________________________________________________________________________________________________
City________________________________________ State________________________________ Zip_______________________________
Bank/Credit Union Name____________________________________________ Account Number________________________________
Routing Number ________________________________ Savings _______________ Checking_______________________________
USPS FCU VISA Number ______________________________________________
I/we authorize the Credit Union to automatically withdraw:
________ 1. The entire outstanding balance as printed on the current billing statement, less any payments received by the Credit Union after the
closing date of the statement.
________ 2. The total minimum payment owed as printed on the current billing statement, including any delinquent, over limit and fee amounts.
________ 3. The fixed whole dollar amount of $_______________ or the outstanding balance if the fixed amount is more. I understand that the
minimum fixed amount must be at least 2% of my credit limit. If I exceed my credit limit or my account becomes delinquent, I am required to
pay the delinquent and/or over the limit amounts if they exceed my fixed payment amount.
Regardless of the plan chosen above, the cardholder’s VISA account will be charged up to $25.00 if the automatic transfer does not occur due to
insufficient funds in the deposit account; or $35.00 if there was the same violation within the last 6 months. Also, the financial institution may
charge your checking/saving accounts with an NSF transaction fee.
I understand that I am still responsible for any amounts due on my VISA account if funds are not available in my deposit account. I understand
that I have the right to terminate the automatic payments at any time by contacting the Credit Union in writing. I understand that if my deposit
account number changes, is closed, or other action is taken, I am responsible for notifying the U. S. Postal Service FCU VISA Department at:
7905 Malcolm Road, Suite 311, Clinton, MD 20735-1730.
Primary Signature
Secondary Signature
Received by ____________________________________________
Date Received____________________________________
Tel: (301) 856-5000
Toll-free: (800) USPS FCU
Fax: (301) 856-4409
U. S. Postal Service Federal Credit Union
VISA Automated Payment Service Agreement
Last Updated: 03/15/12


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