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This document is an enrollment agreement for receiving the mySourceCard MasterCard Debit Card for participants in employer FSA Plans. It details the use and restrictions of the card, as well as the
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How to fill out mySourceCard Enrollment Agreement

01
Begin by gathering all necessary personal information including your name, address, and contact details.
02
Carefully read through the terms and conditions outlined in the agreement.
03
Fill in the required fields, ensuring accuracy in your information.
04
If applicable, provide any supporting documents or proofs that may be required.
05
Review your entries for any errors or omissions.
06
Sign and date the agreement at the designated area.
07
Submit the completed agreement according to the provided instructions.

Who needs mySourceCard Enrollment Agreement?

01
Individuals applying for financial services or assistance programs through mySourceCard.
02
Participants in programs that require enrollment for services related to healthcare or financial management.
03
Clients seeking to manage their spending or access funds through a prepaid card.
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The mySourceCard Enrollment Agreement is a document that outlines the terms and conditions for participating in the mySourceCard program, including eligibility and usage guidelines.
Individuals who wish to enroll in the mySourceCard program and participate in its benefits must complete and file the Enrollment Agreement.
To fill out the mySourceCard Enrollment Agreement, individuals should carefully read the instructions provided, provide required personal information, and sign where indicated. It is important to review the agreement before submission.
The purpose of the mySourceCard Enrollment Agreement is to formally register participants in the program, ensuring they understand and agree to the program's terms and facilitating access to benefits.
The mySourceCard Enrollment Agreement must include personal identification details, contact information, eligibility confirmation, and any other required data as specified by the program guidelines.
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