Member Services Operator

Direct Deposit Enrollment Form

Account Information

Amount

Voided Check

The image of this voided check may be provided to your employer or other payer for no other purpose except to set up direct deposit to your Chime Account. Authorization

I authorize (employer/payer) to initiate credit entries, and, if necessary to initiate any debit entries to correct previous credit errors, to my Chime Spending Account. This authority will remain in effect until I notify my employer or other payor in writing or as otherwise specified by my employer or payer. Banking Services provided by The Bancorp Bank, Member FDIC. The Chime Visa Debit 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. 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. The recipient’s name on any deposits received must match the name of the Chime Member. Any deposits received in a name other than the name registered to the Chime Spending Account will be returned to the originator.

Member Services

844-***-****

*******@*****.***

Name: Adam Maples

Bank Name: The Bancorp Bank

Address: 6100 S Old Village Pl, Sioux Falls, SD 57108 Routing Number: 031101279

Account Number: 389*********

Deposit my entire paycheck. Deposit $ dollars of

my paycheck.

Deposit % of my

paycheck.

VOID

Signature Date

®

The Bancorp Bank

Adam Maples

3251 County Line Rd E,

Lutz, FL 33559

123

A031101279 C389127845144 C123

PAY TO THE

ORDER OF

$

DOLLARS

FOR

Contact this candidate