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Direct Deposit Enrollment Form
Account Information
Name: Arebalo Montero
Bank Name: The Bancorp Bank, N.A.
Address: 6100 S Old Village Pl, Sioux Falls, SD
57108
Routing Number: 031101279
Account Number: 766183848668
Amount
✓ Deposit my entire paycheck Deposit $
paycheck
of my Deposit
paycheck
% of my
Voided Check
The Bancorp Bank, N.A. 123
Arebalo Montero
1508 Jackson Ln, Apt 2
Middletown, OH 45044
PAY TO THE
ORDER OF
FOR
VOID $
DOLLARS
A031101279 C766183848668 C123
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 my employer/payer to initiate credit entries, and, if necessary to initiate any debit entries to correct previous credit errors, to
my Chime Checking Account. This authority will remain in effect until I notify my employer or other payer in writing or as otherwise
specified by my employer or payer.
arebalo montero 2025-05-15
Signature Date
Banking Services provided by The Bancorp Bank, N.A., Member FDIC. The Chime Visa® Debit Card is issued by The Bancorp Bank, N.A. 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.
