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Direct Deposit Enrollment Form


Account Inf ormation
Na m e : Cheryl Hamilton
B a nk Na m e : Stride Bank, N.A.
Ad d re s s : 324 W Broadway Ave, Enid, OK 73701
R o uting Num be r: 103100195
Acco unt Num be r: 248112283473

Amount
Deposit my entire paycheck. Deposit $ dollars of Deposit % of my
my paycheck. paycheck.

Voided Check

Stride Bank, N.A. 123


Che ryl Hamilton

VOID
14323 S Calhoun Ave ,
Burnham, IL 6 0 6 33

PAY TO THE $
ORDER OF

DOLLARS

FOR

A103100195 C248112283473 C123

The i ma g e o f thi s vo i d e d c he c k ma y b e p ro vi d e d to yo ur e mp l o ye r o r o the r p a ye r fo r no o the r p urp o se e xc e p t to se t up d i re c t d e p o si t to yo ur Chi me Ac c o unt.

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.

Signat ure Dat e


B a nk i ng Se rvi c e s p ro vi d e d b y Stri d e B a nk , N .A., M e mb e r F D I C. The Chi me Vi sa ® D e b i t Ca rd i s i ssue d b y Stri d e B a nk , N .A. p ursua nt to a l i c e nse fro m Vi sa U .S.A. I nc . a nd ma y b e
use d e ve rywhe re Vi sa d e b i t c a rd s a re a c c e p te d .
D i re c t d e p o si t c a p a b i l i ty i s sub j e c t to p a ye r' s sup p o rt o f thi s fe a ture . Che c k wi th yo ur p a ye r to fi nd o ut whe n the d i re c t d e p o si t o f fund s wi l l sta rt. F und s a va i l a b i l i ty i s
sub j e c t to ti mi ng o f p a ye r’s fund i ng .
The re c i p i e nt’s na me o n a ny d e p o si ts re c e i ve d must ma tc h the na me o f the Chi me M e mb e r. Any d e p o si ts re c e i ve d i n a na me o the r tha n the na me re g i ste re d to the Chi me
Sp e nd i ng Ac c o unt wi l l b e re turne d to the o ri g i na to r.

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