Prepaid Interview Testing Phase 2

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

Attachment B2 - Prepaid Model Forms and Clauses for Phase 2

Prepaid Interview Testing Phase 2

OMB: 3170-0022

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Form A: Model Clauses for Single-Use Non-Reloadable Card/Reload Packet

THIS IS NOT A PREPAID ACCOUNT
THIS IS NOT A PREPAID ACCOUNT. This product reloads cash onto
your prepaid card.
This is a one-time use card that cannot be reloaded.
Treat this product like cash.
This product charges an inactivity fee of $2 per month if it is not used
within 12 months.
There are no fees associated with the use of this product.

Form B: Short form disclosure as seen on the web

XYZ Prepaid Company
XYZ Prepaid Card
Purchase price: $4.95
Monthly fee
$4.95*

Per purchase

$0 with sig.
$0 with PIN

ATM withdrawal

Cash reload

$0 in-network
$2.00*
$2.00 out-of-network

This card may charge credit-related fees.
ATM balance inquiry (in-network or out-of-network)

$0 or $1.00

Customer service

$1.50 per call

Inactivity (no transactions for 3 months)

$4.50 per month

[Incidence-based fee]

$2.95

[Incidence-based fee]

$3.95

[Incidence-based fee]

$1.00

*Fees can be lower depending on how and where this card is used.
We charge 6 other fees not listed here.
Find details and conditions for all fees and services inside the package
or call 800-234-5678 or visit bit.ly/XYZprepaids.
Register your card with XYZ Prepaid Company to protect your money.
This card does not provide [FDIC][NCUSIF] insurance.
For more information about prepaid cards, visit cfpb.gov/prepaids.

Form C: Short Form Disclosures for Prepaid Accounts With Multiple Service Plans, alternate design 1

Pay-asyou-go plan

Monthly
plan

Annual
plan

Plan fee

$0.00

$4.95 per mo.

$49.95 per yr.

Per purchase

$2.00*

$0

$0

ATM withdrawal

$1.95*

$1.95*

$0

Cash reload

$0

$0

$0

ATM balance inquiry

$1.00*

$1.00*

$1.00*

Customer service

$1.00 per call

$1.00 per call

$0

Inactivity (3 months no use)

$1.95 per mo.

$1.95 per mo.

$0

[Incidence-based fee]

$2.95

$2.95

$2.95

[Incidence-based fee]

$3.95

$3.95

$3.95

This card may charge credit-related fees.
*Fees can be lower depending on how and where this card is used.
We charge 6 other fees not listed here.
Find details and conditions for all fees and services inside the package
or call 800-234-5678 or visit bit.ly/XYZprepaids.
Register your card with XYZ Prepaid Company to protect your money.
This card does not provide [FDIC][NCUSIF] insurance.
For more information about prepaid cards, visit cfpb.gov/prepaids.

Form D: Short Form Disclosures for Prepaid Accounts With Multiple Service Plans, alternate design 2

Plan X

Plan Y

Plan fee

$0

$4.95

Per purchase

$0

$0

ATM withdrawal

$1.95*

$1.95*

Cash reload

$0

$2.00

ATM balance inquiry

$0

$1.00

Customer service

$0

$1.00 per call

Inactivity (3 months no use)

$1.95 per mo.

$1.95 per mo.

[Incidence-based fee]

$0

$2.95

[Incidence-based fee]

$3.95

$3.95

This card may charge credit-related fees.
*Fees can be lower depending on how and where this card is used.
We charge 6 other fees not listed here.
Find details and conditions for all fees and services inside the package
or call 800-234-5678 or visit bit.ly/XYZprepaids.
Register your card with XYZ Prepaid Company to protect your money.
This card does not provide [FDIC][NCUSIF] insurance.
For more information about prepaid cards, visit cfpb.gov/prepaids.


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File Modified2015-04-16
File Created2015-04-01

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