Completing Visa^® Business Check Card Request Form

Cardholder information

• Complete a separate request form for each cardholder for whom a card is requested. Selections may differ among company cardholders.
• Please ensure that you provide the correct address and phone number for the business. The card will be mailed to that address.

Account information

• The cardholder's account access can include up to four business accounts: one interest checking, one non-interest checking, one savings, and one loan account.
• The primary account must be a checking account, and all transactions will be withdrawn from that account.
• For accounts other than the primary account, the cardholder will receive ATM access only.
• The daily spending limit for PIN-less Visa Business credit purchases is set at $1,000. If you would like to increase the dollar limit, please see a banker at any First Citizens branch.
• The daily spending limit on debit transactions with a PIN is $1,000 and the daily limit on ATM transactions is $500.

Password & PIN selection

• Specify a unique password (1-8 alpha characters) for each card requested. This password is used for security purposes in identifying the cardholder. The cardholder must know this password when he or she calls to activate the new Visa Business Check Card.
• Select a unique PIN (4 numeric characters) for each card requested, or one will be provided.

To submit the form:

The form must be signed by the business owner or authorized signer. You may return the form to your local branch, or mail it to:

First Citizens Bank
Mailcode DAC54
P.O. Box 29587
Raleigh, NC 27626-0587