These forms are being provided for your convenience. The forms are in printable formats and may be mailed to us at:
409 Silverside Road, Suite 105
Wilmington, DE 19809
If you have any questions, please call us at 800.473.9595 or email us at email@example.com.
Account Number Request Form
Please fill out and return to the Bancorp in order to receive your employee's account numbers. This form is used to facilitate the funding process for employers. If possible, please type all information into the fields before printing.
In lieu of a paper ACH request, you may utilize our online Funds Transfer functionality to make a one-time or recurring electronic money transfer between your account with us and your account at another financial institution.
Affidavit of Forged or Altered Check
This form will allow a customer to dispute that a check drawn from his/her account was either Forged or Altered. Please complete the form, sign before a Notary Public, and submit to The Bancorp Bank via mail for further processing.
This form will allow a customer to dispute an Automated Clearing House transaction on their account. Please complete the form, sign and submit to The Bancorp Bank for further processing through mail or fax.
This form can be used to update your name, e-mail address, telephone number, and home address information.
This form allows an employer, or other organization to establish direct deposit into a checking and/or savings account that you have selected. Please print this form and provide to your employer or other organization. They will complete the form and set up your funds to auto transfer into your account.
Health Savings Account (HSA) Contribution / Refund Deposit Slip
This form is used when depositing a refund check to your HSA or mailing in an HSA contribution.
Use this form to instruct The Bancorp Bank to transfer or rollover your Health Savings Account at another institution to a new account at The Bancorp Bank .
With this form an employer can make an initial deposit on behalf of multiple Health Savings Accounts for its employees.
Please complete this form to report and correct an excess contribution to your Health Savings Account made during the current tax year.
Use this form to instruct The Bancorp Bank to transfer or rollover your IRA at another institution to an HSA account at The Bancorp Bank.
Use this form to instruct The Bancorp Bank to transfer or rollover your Medical Savings Account at another institution to a new account at The Bancorp Bank.
This form allows a customer to designate another person to manage their account(s) at The Bancorp Bank. This person will have complete control of the account(s), however the power of attorney ceases to be recognized by The Bancorp Bank upon death of the accountholder. Please print, sign, notarize and submit this form to The Bancorp Bank for further processing by mail.
Remove Account Signer Request
Use this form to remove an authorized signer from your account.
This form allows for a customer to stop the payment of a check or ACH on an account. Please call the toll-free number listed in the customer service tab to place the stop payment. A stop payment is only valid for 14 days without this signed and submitted form. Once the form is received by The Bancorp Bank the stop payment will be valid for 6 months.
Complete this form to transfer funds by wire to another U.S. bank.
Complete this form to transfer funds by wire to a non-U.S. bank.
In order for businesses and trusts to transfer funds by wire to another bank, this form must be on file with the Bank. Please complete and return the form to the Bank, before you initiate your first wire transfer (return contact information is provided on the last page of the agreement; you only need to complete the form once). From the date we receive your completed form, please allow at least two business days before initiating your first wire transfer. A Caller ID and PIN number will be issued to each authorized representative in order to initiate a wire transfer via fax, email, or telephone. Please allow up to ten business days for our mailing and your return of the PIN Acknowledgement Form.
Note: Those with individual/joint accounts should not complete this form, unless to provide authorization of a third party, such as a financial professional, to send wires on your behalf.
For an incoming wire transfer to your The Bancorp Bank account from a U.S. or non-U.S. bank.
For an outgoing wire transfer from your The Bancorp Bank account to a U.S. or non-U.S. bank.
This form must be completed by a non-U.S. resident or business owner who does not have a U.S. Social Security Number (SSN) or Tax Identification Number (TIN).