Bank Freedom Card - Prepaid MasterCard

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First Name*

M.I.

Last Name*

Address* (PO Box not allowed)

Apt. Number

City*

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Zip Code*

Phone*

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Email Address*

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Bank Freedom Prepaid Card is issued by MetaBank pursuant to license by MasterCard International Incorporated. MasterCard is a registered trademark of MasterCard International Incorporated. Bank Freedom is an authorized Independent Sales Organization ("ISO") of MetaBank. Member FDIC. Subject to funds availability. Transaction fees, Terms and conditions apply. All trademarks, service marks and registered marks are the properties of their respective owners. © 2007-2008 Bank Freedom. All rights reserved.

**The USA PATRIOT Act is a Federal law that requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. You will be asked to provide your name, address, date of birth, and other information that will allow us to identify you. You may also be asked to provide documentation as proof of identification. "100% Approval", "Guaranteed Approval", and "No one is Turned Down" is contingent upon successfully passing this mandatory identification confirmation.