Direct Deposit Enrollment Form

Account Information Questions?

Name: james ortize moneylion.com/support
Bank Name: MetaBank
Account Type: Demand Deposit Account
Routing Number: 073972181
Account Number: 271118381141

Amount

Deposit my entire paycheck. Deposit $ dollars Deposit %

of my paycheck. of my paycheck.

Voided Check

VOID
james ortize
898 Archer St
Monterey, CA 93940

271118381141

This image of this voided check may be provided to your employer or other payer for no other purpose except to set up direct
deposits to your RoarMoney account.

Authorization
I authorize Safeway pharmacy to initiate credit entries, and, if necessary to initiate any debit entries to
correct previous credit errors, to my RoarMoney 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.

james ortize
April / 11 / 2022

Signature Date

RoarMoneySM demand deposit account provided by, and MoneyLion Debit Mastercard® issued by, MetaBank®, National
Association, Member FDIC. RoarMoney is a service mark of MoneyLion, which offers and provides services for the RoarMoney
Account among its suite of financial products and services. Mastercard is a registered trademark, and the circles design is a
trademark of Mastercard International.
Direct deposit capability is subject to payer’s support of this feature. Check with you payer to find out when the direct deposit of
funds will star. Funds availability is subject to timing of payer’s fundings.
The recipient’s name on any deposits received must match the name of the RoarMoney account holder. Any deposits received in
a name other than the name registered to the RoarMoney account will be returned to the originator.