DIRECT DEPOSIT FORM 2

Direct deposit form

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Please review the following information:

NAME ON THE ACCOUNT ANGELA MCCALLISTER

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DATE 12/25/2023
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STREET ADDRESS 5821 Maccorkle Ave, # 25177

CITY, STATE, ZIP SAINT ALBANS, WV, 25177

Account

BANK NAME The Bancorp Bank, N.A.

Choose your deposit amount

(pay per cycle)

Entire paycheck

% of paycheck

Set amount

I wish to have my check directly deposited into my Card Account. I authorize you (my
employer or payor) to initiate entries and, if necessary, debit entries and adjustments for
any credit entries in error to my Card Account each pay period. This authority will remain in
effect until I notify my employer or other payor in writing or as otherwise specified by my
employer or payor.

SIGNATURE

R/T (ROUTING) NUMBER 114924742

ACCOUNT NUMBER 9825044907068

We do not accept deposits via wire transfers. We do not accept printed checks. Any printed checks sent to
us, or to the issuing bank will be returned or destroyed. Direct Deposit must be made in the name of a valid
cardholder on this Card Account. If you wish to receive Direct Deposits to this Card Account from a
household member's employer, for example, you must add a card to this Card Account in the household
2
member's name. There is an Additional Card Fee to add a card for your household members. See the
Cardholder Agreement for details. Direct Deposit capability is subject to payor's support of this feature.
Check with your payor to find out when the direct deposit of funds will start. Funds availability is subject to
timing of payor's funding.
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IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the
government fight the funding of terrorism and money laundering activities, Federal law requires all
financial
Move Moneyinstitutions to obtain, verify, and record information that identifies each person who opens an

account. WHAT THIS MEANS FOR YOU: When you open an account, we will ask for your name, address,
date of birth, and other information that will allow us to identify you. We may also ask to see your driver's
license
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The PayPal Prepaid Mastercard is issued by The Bancorp Bank, N.A. Member FDIC, pursuant to license by
Mastercard International Incorporated. Netspend, is an authorized representative of The Bancorp Bank,
Account
N.A. Certain products and services may be licensed under U.S. Patent Nos. 6,000,608 and 6,189,787. Use
of the Card Account is subject to activation, ID verification and funds availability. Transaction fees, terms,
and conditions apply to the use and reloading of the Card Account. See the Cardholder Agreement for
details.

Mastercard is a registered trademark, and the circles design is a trademark of Mastercard International
Incorporated.

Card may be used everywhere Debit Mastercard is accepted.

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