CONTACT UPDATE FORM

Contact ICBA Bancard
Tel: 800-242-4770
Email: bancard@icba.org

If ICBA Bancard should add or change a contact person for your financial institution, please complete this form:

Plan Manager Contact Information:

Primary Credit Card Plan Manager Name:

Primary Credit Card Plan Manager Title:

Primary Credit Card Plan Manager's Email:

Secondary Credit Card Plan Manager Name:

Secondary Credit Card Plan Manager Title:

Secondary Credit Card Plan Manager's Email:

Debit Card/ATM Plan Manager Name:

Debit Card/ATM Plan Manager Title:

Debit Card/ATM Plan Manager's Email:

Card Fraud Contact Name:

Card Fraud Contact Title:

Card Fraud Contact's Email

Merchant Plan Manager Name:

Merchant Plan Manager Title:

Merchant Plan Manager's Email:

Bank Name

Address

City

*State:

*Zip:

*Phone:

*Fax:

*E-mail:

Comments:

I attest that I am authorized to make the above changes for our bank plan managers' contact information.

*Person Completing this Form

Type the code from the image

PRIMARY Plan Managers receive announcements and action-required notices, including:

ALL OTHER contacts receive: