These forms are being provided for your convenience. The forms are in printable formats and may be faxed to the number on the form or mailed to us at:
409 Silverside Road, Suite 105
Wilmington, DE 19809
If you have any questions, please call us at 800.650.5904.
Account Closure Request Form
Use this form to close an existing account and provide instruction for return of funds if applicable.This form can NOT be used to close IRA accounts.
ACH Loan Payment Authorization Form
Complete this form to authorize the Bank to electronically transfer funds through the Automated Clearing House (ACH) system from your deposit account at another financial institution to the Bank in payment of a loan.
You should use our online Funds Transfer service tool to make a one-time or recurring electronic money transfer between your account with us and your account at another financial institution.
Use this form to add an additional owner to your account.
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 Bank for further processing through mail or by faxing to the number provided on the form.
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.
ATM/Debit Card Dispute Form
Complete this form to report the unauthorized use of your ATM/debit card, a point-of-sale (POS) transaction error or dispute, or an incorrect disbursal of cash by an ATM.
Auto Payment Authorization – Internal Transfer Request
Complete this form to authorize the Bank to transfer funds from your deposit account with the Bank in payment of a loan with the Bank.
This form can be used to update your name, e-mail address, telephone number, and home address information.
This form, approved by the board of directors of a corporation, specifies which individuals are to be permitted to transact banking business on behalf of the company. This must be completed each time signers change and must be signed and submitted to the Bank for further processing by mail.
This form is used when depositing check(s) to your account.
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.
Interest Capitalization Form
Use this form to request or terminate automatic advances of monthly interest payments from a securities-backed line of credit.
By completing this form, you authorize the Bank to make one-time money transfers between accounts at the Bank. Only an authorized signer or account owner of the account from which funds are being transferred may initiate the request.
IRA Distribution Request Form
This form should be utilizes when requesting full or partial distributions from your IRA (Traditional, SEP and SIMPLE IRAs).
IRA Transfer Request Form
This form should be used when rolling an IRA held at another financial institution, into an existing IRA held at this institution. Once this form is submitted the bank will forward this request to the financial institution you indicate.
This form will allow customers to make automatic contributions into IRA accounts.
This form allows an LLC to establish which individuals are to be permitted to transact banking business on behalf of the company. This must be completed each time signers change and must be signed and submitted to the Bank for further processing by mail.
This form allows a partnership to establish which individuals are to be permitted to transact banking business on behalf of the company. This must be completed each time signers change and must be signed and submitted to the Bank for further processing by mail.
Payable on Death (POD) Beneficiary Designation Form
Use this form if you wish to name one or more individuals as pay-on-death beneficiaries on your checking or savings account. Upon the death of all primary account owners, the named beneficiaries will automatically be deemed owners of the account. See Form instructions for important information.
This form allows a customer to designate another person to manage their account(s) at the Bank. This person will have complete control of the account(s), however the power of attorney ceases to be recognized by the Bank upon death of the account holder. Please print, sign, notarize and submit this form to the Bank for further processing by mail.
Remove Account Signer Request
Use this form to remove an authorized signer from your account.
Request to Add or Change Third-Party Statement Recipient
This form will allow you to add or update information regarding the third parties that receive copies of your statements.
This form will allow a signer on an account to use a stamp on checks and other documents for their signature instead of hand signing the document. A color stamp must be used to deter fraud. Please print, hand sign, facsimile stamp the form and submit to the Bank for further processing. Facsimile signatures will not be accepted by us without this completed form.
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 Bank the stop payment will be valid for 6 months.
Treasurer's Check Request Form For Securities-Backed Line of Credit
Use this form to request a Treasurer’s Check from your securities-backed line of credit with the Bank.
Use this form for filing evidence of a trust without having to record the entire trust document.
Use this form when applying for a Securities-Backed Line of Credit for a Trust.
Complete this form to transfer funds by wire to another U.S. bank.
Note:If you are wiring funds from a commercial or trust deposit account, or if you have an individual/joint deposit account and want to authorize a third party, such as a financial professional, to send wires on your behalf, a completed Wire Transfer Services Application and Agreement (see form below) must be on file with The Bancorp Bank.
Complete this form to transfer funds by wire to a non-U.S. bank.
Note: Note: If you are wiring funds from a commercial or trust deposit account, or if you have an individual/joint deposit account and want to authorize a third party, such as a financial professional, to send wires on your behalf, a completed Wire Transfer Services Application and Agreement (see form below) must be on file with The Bancorp Bank. For international wire transfer requests initiated by a consumer (individual/joint deposit account), you will have 30 minutes to cancel your request after you have been sent a disclosure indicating fees that may be assessed, and the exchange rate (if applicable).
In order for Bank customers with commercial or trust deposit accounts to transfer funds by wire to another bank, this form must be on file with The Bancorp Bank. Please complete and return the form to The Bancorp Bank before initiating your first wire transfer request (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 the completed form, please allow at least two business days before initiating your first wire transfer request. A Caller ID and PIN will be issued to each authorized representative by secure email or by mail. Please sign and return the PIN Acknowledgement Form to activate security credentials (Caller ID and PIN) in order to initiate a wire transfer request via fax, mail, or telephone.
Note: If you are an owner of an individual/joint account, you should not complete this form, unless to provide authorization of a third party, such as a financial professional, to send wires on your behalf.
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 to send wires on your behalf.
Complete this form to make a one-time domestic or international wire transfer of funds advanced from your Bancorp Securities-Backed Line of Credit account.
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).
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.