Zions Bank is a
division of Zions Bancorporation, N.A. Member
F
D
I
C
Servicemembers
Civil Relief
A
c
t
Request for Relief F
o
r
m
To: Zions Bank
SCRA SERVICING UNIT
Mail Code UT-ZTC-1850
7860 South Bingham Junction Blvd.
Midvale, UT 84047
I, the
servicemember
(or the legal
representative
of the
servicemember)
whose name and
signature
appear below,
h
e
r
e
by
request benefits and
protections
under the
Servicemembers
Civil Relief Act for the loan, credit card, and
d
e
pos
i
t
a
ccoun
t
s
identified b
e
l
o
w
.
Name of
Servicemember
Name of
Servicemember
’
s
Spouse (if
applicable)
1
Contact
Phone
Number
Contact
Phone
Number
Home
Address
Home
Address
City,
State,
ZIP
City,
State,
ZIP
Mailing
Address
Mailing
Address
(If different from Home Address) (If different from Home Address)
City,
State,
ZIP
City,
State,
ZIP
Servicemember's
Agent under a Power of
Attorney
(if
applicable)
Servicemember's Attorney
(if
a
pp
li
c
a
b
l
e)
Contact
Phone
Number
Contact
Phone
Number
Best
Address
Best
Address
City,
State,
ZIP
City,
State,
ZIP
Note: The
customer information
above will not be used to update your bank account records. This
information
will
b
e
used solely for contact purposes
associated
with the
Servicemembers
Civil Relief
A
c
t
.
Military
I
n
f
o
r
m
a
t
i
on
Branch
of
Service
Military
Unit
Number
Military
Unit
Name
Active
Duty
Start
Date
Active
Duty
End
Date
1 If your spouse has accounts with Zions Bank solely in his/her name and you reside in a community property state (AZ, CA, ID, LA, NV, NM,
WA, WI, AK) or Puerto Rico, those accounts may be eligible for SCRA relief. If you would like Zions Bank to determine if such accounts, if any,
are SCRA-eligible, please provide the information requested. We will not use this information for any other purpose.
Zions Bank is a
division of Zions Bancorporation, N.A. Member
F
D
I
C
(Page 2)
Servicemembers
Civil Relief
A
c
t
Request for Relief F
o
r
m
Account Information
(if you have more accounts, attach separate page):
Loan
Number
Loan
Number
Loan
Number
Loan
Number
Credit
Card
Number
Credit
Card
Number
Credit
Card
Number
Credit
Card
Number
Deposit
Acct
Number
Deposit
Acct
Number
Deposit
Acct
Number
Deposit
Acct
Number
I certify that I am the servicemember identified above and that I and/or my spouse is, as applicable, a borrower or signer on each
loan, credit card, or deposit account identified above. I also certify that any loan account identified above was opened before I
entered active duty military service.
I request that Zions Bank cap the interest rate and fees on each identified loan and credit card account at 6% APR and lower the
required monthly payment accordingly during the term of my active duty military service plus an additional period of: (a) 12 months
for any loan account secured by real property or (b) 6 months for any credit card account or loan account not secured by real
property. I further request that Zions Bank waive all NSF fees charged on any deposit account identified above during the term of
my active duty military service. I further request that Zions Bank determine if any loan, credit card, or deposit account identified
above is eligible for reimbursement of interest or fees.
I agree that if my Active Duty End Date changes, I will provide Zions Bank with proof of such change so that Zions Bank may
change my SCRA benefit period(s) accordingly.
I have enclosed a copy of my orders (and any amendments) calling me to active duty military service, as required by the
Servicemembers Civil Relief Act.
If I am making a request for SCRA relief as the legal representative of the servicemember identified below, I certify that I am
authorized by the servicemember to make such a request and to communicate with Zions Bank on all matters relating to the
request.
SERVICEMEMBER LEGAL REPRESENTATIVE OF SERVICEMEMBER
(signature)
(signature)
(printed name)
(printed name)
(Date)
(Date)
Please return the
Servicemembers
Civil Relief Act Request for Relief Form, the
Servicemembers
Civil Relief
A
c
t
Reimbursement
Consent Form, and a copy of your active duty
military
orders (and any amendments) to one of
t
h
e
following
a
dd
r
e
ss
e
s
:
If by U.S. Mail: If by Email
A
tt
a
ch
m
e
n
t:
SCRA
Servicing
Unit
SCR
A
un
i
t
@
z
i
onsb
a
nco
r
p
.
co
m
Mail Code UT-ZTC-1850
7860 South Bingham Junction Blvd.
Midvale, UT 84047
