I want to sign-up for a RushCard.
>> TELL US ABOUT YOURSELF Print out this page and fill out the form, completely. Please write clearly and provide as much
information as you can. Remember: We will not be able to process the application without all the information marked (required).
>> SUBMITTING APPLICATIONS Applications can be submitted by phone, by calling 866-RUSHCARD, online at www.rushcard.com or by mailing this completed form to: RushCard Applications Center 22068 Network Place Chicago, IL 60673-1220 Once you've submitted your application, you should receive your card in 7-10 business days. With your RushCard in hand, simply add money and then use your card to pay bills, shop online and at over 800,000 locations worldwide where Visa® debit cards are accepted.
RUSHCARD APPLICATION
New Cardholder Information Which RushCard will you choose? Activate my RushCard Now
I am enclosing a money order or personal check for my activation fee of $19.95 I would also like to load additional funds to my Card in the amount of $_______
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING AN ACCOUNT Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. In the event of an incomplete application or non-verifiable information, a RushCard Agent will contact you. If information can not be verified, your application and activation fee will be returned to you. PLEASE DO NOT SEND CASH
Please tell us about yourself
Please print in black or blue ink, one character to a box First Name
Middle Initial
Last Name
Social Security Number (required)
Date of Birth (required)
Home Telephone (required)
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State
Driver's License Number (if available)
Street Address (required)
Apt Number
City (required)
State (required)
Zip (required)
Email Address
X Signature (required)
Did a friend tell you about RushCard?
Authorization: I certify that I have provided complete and truthful information above.
Please enter the User ID or Email Address of the referring RushCard Member
Schedule of Fees
Activation Fee Active Card Monthly Maintenance Fee Adding Funds at Loading Points (MoneyGram®)* Adding Funds via Money Order Adding Funds via Bank Transfer** Adding Funds via Payroll Direct Deposit Adding Funds via Tax Refund View Statement Online $19.95 FREE FREE FREE FREE FREE FREE FREE Convenience Fee on Purchases*** ATM Cash Withdrawal Fee (Domestic) ATM Cash Withdrawal Fee (International) ATM Balance Inquiry Fee (Domestic) ATM Balance Inquiry Fee (International) Account Maintenance on Inactive Cards† Refund of Account via Check RUSH Bill Pay†† $1.00 $1.95 $3.50 $0.50 $1.00 $2.95 $5.00 $1.00
***Up to first 10 transactions per month, refunded thereafter †Inactive accounts - 60 days of no loads, no purchases and no ATM activity ††A one time $2.00 enrollment fee charged with first use of RUSH Bill Pay service The Prepaid Visa® RushCard is issued by Manufacturers and Traders Trust Company pursuant to a license from Visa U.S.A. Inc. and is only available to residents of the United States (except Vermont) with valid social and Traders Trust Company pursuant to a license from Visa U.S.A. Inc. and is only available to residents of the United States (except Vermont) with a valid social security number. The Prepaid Visa® RushCard is issued byaManufacturers security number.
*MoneyGram charges a flat rate for all transfers up to $1,000 per day **Your issuing bank may charge a fee for money transfers