Direct Deposit Form

Download as pdf or txt
Download as pdf or txt
You are on page 1of 2

ENROLL IN DIRECT DEPOSIT

Simply fill out this payroll direct deposit form and give the form to your payroll department or government
benefits office. It works like any other direct deposit program. Your funds will be electronically sent to your card
every pay period. If you do not see your account number below, sign in to your card account at
www.myvanillacard.com or call 1-855-686-9513 toll-free and follow the prompts for adding money through
direct deposit.

NAME : STEVEN SKJERSETH

ACCOUNT TYPE : Checking

ROUTING NUMBER : 063115194

ACCOUNT NUMBER : 0001108919927

CHOOSE AMOUNT TO DEPOSIT:

100% of pay Other % of pay: _______% Set amount: $________

DIRECT DEPOSIT AUTHORIZATION


I agree to the Direct Deposit Terms and Conditions noted below and authorize my employer or benefits provider
("Payor") to initiate credit entries to my MyVanilla Card account. The authorization will remain in effect until the
Payor has received written notification from me of its termination in such time and in such manner as to afford
the Payor and The Bancorp Bank a reasonable opportunity to act on it.

____________________________________________________________ ______________________________
Signature Date
Please call Customer Care at 1-855-686-9513 with any questions. Direct Deposit Terms and Conditions: The MyVanilla Card is issued by The Bancorp Bank, Member FDIC,
pursuant to a license from Visa U.S.A. Inc. and may be used everywhere Visa debit cards are accepted. I understand that I have the option of receiving all or part of my wages,
expense reimbursements, bonuses, and other employment-related or government benefit payments (“Payments”) from the Payor by electronic funds transfer to my MyVanilla
Card (“Card”) issued by The Bancorp Bank. I authorize the Payor to make Payments to my MyVanilla Card by initiating electronic entries (and, if necessary, debit entries and
adjustments for any credit entries in error) to my MyVanilla Card account. I understand that: (i) I may cancel this authorization at any time by sending a written notice to the
Payor at least 5 business days in advance of any payment; (ii) Payor may terminate this method of payment, with or without cause, at any time; (iii) Payments made to my
MyVanilla Card will be subject to the terms of my MyVanilla Card Cardholder Agreement with The Bancorp Bank; (iv) I may continue to receive Payments by check or (if
applicable) direct deposit to a The Bancorp Bank account until this authorization is processed and my Payments are added to my MyVanilla Card; and (v) funds from electronic
direct deposits will generally be available on the day The Bancorp Bank receives the deposit. I also understand that, in case of transmission error or deposit irregularity, my
ability to withdraw funds may be delayed beyond the day The Bancorp Bank receives the deposit, in which case the funds will generally be available for withdrawal within 5
business days after the deposit. Your Prepaid Card Account and associated direct deposit account number cannot be used for preauthorized direct debits from merchants or
from utility or Internet service providers.

Direct deposit capability is subject to payer’s support of this feature. Check with your payer to find out when the direct deposit of funds will start. Funds availability is subject to
timing of payer’s funding.

Your prepaid card account and associated direct deposit account number cannot be used for preauthorized direct debits from merchants or from utility or Internet service
providers. If presented for payment, these preauthorized direct debits will be declined and your payment to the merchant or provider will not be processed. The bank routing
number and direct deposit account number are for the purpose of initiating direct deposits to your prepaid card account only. You are not authorized to provide this bank
routing number and direct deposit account number to anyone other than your employer or payer.

The MyVanilla Prepaid Visa Card is issued by The Bancorp Bank, pursuant to a license from Visa U.S.A. Inc. and may be used everywhere Visa debit cards are accepted. The
MyVanilla Prepaid Mastercard is issued by The Bancorp Bank pursuant to license by Mastercard International Incorporated and may be used everywhere Debit Mastercard is
accepted. Mastercard is a registered trademark, and the circles deign is a trademark of Mastercard International Incorporated. The Bancorp Bank, Member FDIC.

You might also like