Model Form C

Prepaid Form C Summary Static_Mult Fee Plan_QR (12-20-13).pdf

Generic Clearance for Development and/or Testing of Model Forms, Disclosures, Tools, and Other Similar Related Materials

Model Form C

OMB: 3170-0022

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ABC Prepaid Card
We may also charge other fees not listed here. For a full list of fees, terms, and conditions, visit
www.ABCPrepaid.com/fees, scan the QR code to the right, or see the enclosed account agreement.
Monthly
Plan
$0/$5.95
$9.95*
$4.95 per month
$0
$3.95 or less**
$0/$2.50**/$5.00**

Pay-As-YouGo Plan
$0/$5.95
$0
$4.95 per month

Purchase (with signature/with PIN)
Make
Purchases Online bill pay

$0
$0

$1.00/$2.00
$2.00 per trans.

ATM balance inquiry (in-network/out-of-network/international)
Get
Online or automated by phone
Account
Live agent customer service
Information
Access to electronic transaction history

$0/$2.50**/$5.00**
$0
$2.50 per call

$0/$2.50**/$5.00**
$0
$2.50 per call

$0

$0

Initial purchase of card (online/in-store)
Set-Up & Monthly fee
Maintenance
Inactivity (if no transactions for 3 months)
Add &
Withdraw
Money

Direct deposit
Cash reload
ATM withdrawal (in-network/out-of-network/international)

$0
$3.95 or less**
$0/$2.50**/$5.00**

*Your first monthly fee will be charged 30 days from when you register your card or 60 days after card purchase, whichever
comes first.
**Third party fees may also apply.
No overdraft fees.
Security of Funds: Your money is not protected against unauthorized transactions until you register this card. Funds
FDIC-insured upon registration. Your funds will not expire due to inactivity.
For More Information:
• For more information about prepaid cards, including comparison shopping resources, visit prepaids.consumerfinance.gov.
• For questions or complaints about ABC company, contact the Consumer Financial Protection Bureau at 855-411-2372,
855-729-2372 (TTY/TDD) or consumerfinance.gov.
In Case of Account Errors: You have a right to dispute errors. If you think there is an error, contact us at 888-123-4567 or
www.ABCPrepaid.com. You can also contact us for a written explanation of your rights.
To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial
institutions to obtain, verify, and record information that identifies each person who purchases a product like this card.

Form C – Summary, Static


File Typeapplication/pdf
AuthorAmy Newell
File Modified2014-01-03
File Created2014-01-03

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