Arbitration Opt Out Form

You must complete the information below in order to request to opt out of Pathward, National Association arbitration provisions.

If you would like to receive confirmation of your request to opt out, please complete the optional email address field and check the box at the bottom of the page prior to clicking the "Submit" button.


Primary Account Holder Information
Last 4 Digits of Primary SSN*:	- -

First Name*:

Last Name*:

Secondary Account Holder Information (if applicable)
Last 4 Digits of Spouse SSN*:	- -

First Name:
Last Name:
Your Address and Contact Information Check this box if you do not have a U.S. address.
Street Address 1*:
Please enter Street Address..
Street Address 2:

City*:
Please enter City.
State*:
Please select State.
Zip*:
Please enter Zip Code.
Phone Number:

Email Address*:
Please Enter email..
Confirm Email Address*:
Please Enter email..

Check this box if you would like an email confirmation of this election (email address required)?

*Required field