EFTA00186545¶
| Metaxa Corporation CREDIT CARD ACCOUNT MAIN LINANCE Credit Card Services | ||
| Acct # Name HDam Perril Land Business Name Wes, LLC Account Record Changes ☑ Grade Account ☐ Cards Returned ☐ Cards Not Returned ☐ Re-Open Account ☐ Remove Reissue Block Add Soc. Sec.: # Add Telephone # Home Business Name Change From: To: Address Change to City, State, ZIP Add Cardholder Order Card ☐ Do Not Order Card Delete Cardholder Add Authorized User Order Card ☐ Do Not Order Card Delete Authorized Rating Delete Credit Rating Add Type Code Delete Type Code Add Automatic Payment Detection T/R# Checking Acc# Minimum payment Delete Automatic Payment Deduction Add Email Address Mother's Maiden Name Add Secondary CH SS# Add Secondary CH DOB Add Secondary CH Daytime Phone Add Fax Number Add Cell Phone# Add Pager Number Privacy Option InsuranceAdd InsuranceDelete Insurance*Add insurance, attaches a signed copy of the insurance applicationFree Text Messages/Miscellaneous Instructions | For Marital Property States Only☐ Married ☐ Not Married ☐ Legally Separated Spouse's Name Street AddressCity State, ZIPCard State Issue☐ Order New Card for Most mark below to indicate the type of card orderedSend Card: Normal Delivery - 7 to 10 daysExpress Delivery - 2 days ($10.00 charge)Saturday Delivery ($10.00)Fastcard - 1 day ($20.00 charge)Saturday Delivery ($10.00)Charge: Cardholder Financial InstitutionAddress to Mail Card:NameStreet AddressCity, ST ZIPCharge Cardholder Replacement Card Fee of $PIN Insurance☐ Order PIN ReminderPIN Federal Express - 3 days ($10.00 charge)Change: Cardholder Financial InstitutionSend PIN to Alternate Address BelowNameStreet AddressCity, State, ZIPBalance/Payment TransfersTransfer balance of$From account#To account#Transfer payment of$From account#To account#Convenience Checks☐ Send Convenience Checks - # of booksNameStreet AddressCity, State, ZIP | |
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