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Visa Debit Card Information        
* Card Number:        
Name on Card:          
* First Name:   MI:  
* Last Name:        
* Address:  
* City: * State  
      * Zip  
* Daytime Phone Number:      
  Evening Phone Number:  
Travel Details:    
* Start Date:


End Date:  
* Location(s):  
 *REQUIRED Entries     ...............    
Please allow 48 hours for this information to be updated to Visa. Request after 3:00 PM Friday will be processed the following Monday.

Thank you for using Johnson City Bank. Your travel plan details have been documented and we wish you a safe trip. If you have any further questions please call (830) 868-7131.