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    Direct Deposit Enrollment Form

    Account Information
    Name: Scott Dineen
    Bank Name: The Bancorp Bank
    Address: 6100 S Old Village Pl, Sioux Falls, SD
    57108
    Routing Number: 031101279
    Account Number: 333319938515

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

    Voided Check

    The Bancorp Bank 123


    Scott Dineen
    693 Pleasant St,
    Norwood, MA 02062

    PAY TO THE
    ORDER OF

    FOR
    VOID $

    DOLLARS

    A031101279 C333319938515 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.

    August 4, 2023
    Signature Date
    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.

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