Prepaid Debit MasterCard™ |
Send a $29.95 cashier’s check / US Postal Services Money Order along with this form to the address below or give to the authorized agent for processing, $10 will be pre-loaded on your new Prepaid Debit MasterCard™ready for immediate use. (card delivered within 10 days) First Name: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ____ Last Name: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ _ ___ ___ Mail Address : ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ __ |
Street Address: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
City: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ __
STATE: ___ ___ ZIP: ___ ___ ___ ___ Agent Number: __________
TELEPHONE: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
SSN #: ___ ___ ___ ___ ___ ___ ___ Date of Birth ___ /___/___
StressFreeMoney Phone: (866) 849-1126
P.O. BOX 1003
Lake Dallas, Texas 75065
E-mail address: Info@stressfreemoney.com
Please visit our website for more information. http://www.stressfreemoney.com
