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When you call you must have your provider number and your bank or pay card routing and account numbers for the IHSS Service Desk to assist you with completing your form. SECTION A - PAYEE INFORMATION.


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Card may be used everywhere Visa debit cards are accepted.

. Area Code - SECTION B - DEBIT CARD AUTHORIZATION. Debit card fees are always shown on your debit card account statement which you may review online or by telephone at no cost. This number is also listed on the back of your card.

Unauthorized access is prohibited and may result in corrective action up to and including termination andor civil or criminal prosecution. The IHSS Service Desk can be reached during Business Hours 800 am- 500 pm. The ISP List is a database of Internet service and other online content providers that will help you get the information you need for your case.

The Platinum smiONE Visa Prepaid Card is issued by The Bancorp Bank pursuant to a license from Visa USA. Monday through Friday excluding major holidays. By signing this form I authorize the Division of Child Support Services DCSS to share information with SMI Card Services LLC smiONE for the purpose of establishing a smiONE Visa Prepaid Card account for me and to deposit my child support payments to my card account.

NAME First Middle Last ADDRESS PO Box or Street Address Apt. Enter the required. CITY STATEPROVINCE ZIP.


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