VISA Debit Card Transaction Parameter Release Authorization Form

VISA is currently restricting transactions (both point-of-sale and online) in the following countries:

- AE (United Arab Emirates)
- AU (Australia)
- BE (Belgium)
- BR (Brazil)
- FR (France)
- IN (India)
- IS (Iceland)
- MA (Morocco)
- NG (Nigeria)
- PK (Pakistan)
- RO (Romania)
- SA (Saudi Arabia)
- SI (Slovenia)
- TW (Taiwan)
- TR (Turkey)
- VA (Holy See - Vatican City State)
- ZA (South Africa)

If you plan to process transactions in any of the countries on the above list or will be traveling to any of these jurisdictions, you will need to complete and submit this form at least 36 hours prior to the release date.

Cardholder's Details

First Name

Last Name

Last 4 digits of card number

Registered Email

Parameter Release Start Date

Parameter Release End Date

Vendor/Store Name (optional)

Location of Vendor(s)

I hereby acknowledge and give my consent to the release of transactional parameters on the above stated card in the above stated country. I declare and acknowledge that the card issuer has implemented transactional parameters to mitigate the risk of fraud, that releasing the parameters on the card could expose it to potential fraud risks and that any unauthorized movement will be my entire responsibility as a cardholder whether personal or business. By submitting, I also agree to the Terms of Use and Privacy Policy.

NOTE: For individual transactions, the transactional parameter will be released for a maximum of six (6) hours to facilitate the processing of the transactions and prevent any declines.