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Forms

Online Wire Requests Banner

These forms are being provided for your convenience. The forms are in printable formats and may be faxed to the number on the form or mailed to us at: 

Premier LOC
409 Silverside Road, Suite 105
Wilmington, DE 19809

The following forms can now be executed with electronic signature through DocuSign. Process MUST be initiated by a Bancorp representative. Please contact us to get the process started.

• ACH Loan Payment Authorization

If you have any questions, please call us at 855.420.9467.

ACH Loan Payment Authorization Form
Complete this form to authorize The Bancorp Bank, N.A. (Bank) to electronically transfer funds from your deposit account at another financial institution to the Bank in payment of a loan through the Automated Clearing House (ACH) system. The DocuSign feature is available for this form. Process MUST be initiated by a Bancorp representative. Please contact us to get started.

Affidavit of Forged or Altered Check
This form will allow a customer to dispute that a check drawn from his/her account was either Forged or Altered. Please complete the form, sign before a Notary Public, and submit to The Bancorp Bank, N.A. via mail for further processing. 

Affidavit of Unauthorized ACH
This form will allow a customer to dispute an Automated Clearing House transaction on their account. Please complete the form, sign and submit to the Bank for further processing through mail or by faxing to the number provided on the form.

Change in Terms
Use this form to request change in terms to a line of credit account.

Change of Contact Information
This form can be used to update your name, e-mail address, telephone number, and home address information.

Change Third-Party Statement Recipient
This form will allow you to add or update information regarding the third parties that receive copies of your statements.

Interest Capitalization Form
Use this form to request or terminate automatic advances of monthly interest payments from a line of credit.

Resolution for Facsimile
This form will allow a signer on an account to use a stamp on checks and other documents for their signature instead of hand signing the document. A color stamp must be used to deter fraud. Please print, hand sign, facsimile stamp the form and submit to the Bank for further processing. Facsimile signatures will not be accepted by us without this completed form.

Stop Payment
This form allows for a customer to stop the payment of a check or ACH on an account. Please call the toll-free number listed in the contact us tab to place the stop payment. A stop payment is only valid for 14 days without this signed and submitted form. Once the form is received by the Bank the stop payment will be valid for 6 months. 

Treasurer's Check Request Form For Line of Credit
Use this form to request a Treasurer’s Check from your line of credit with the Bank.

Trustee Certification/Affidavit for Line of Credit
Use this form when applying for a line of credit for a Trust.

Wire Request Form for Line of Credit (Domestic & International)

Electronic Signature            Physical Signature
Complete this form to make a one-time domestic or international wire transfer of funds from your line of credit account with The Bancorp Bank, N.A.

Wire Transfer - Standing Instructions Form (Domestic)
Complete this form to authorize The Bancorp Bank, N.A. to record or update the originator and beneficiary information as standing instructions for domestic wire transfer requests.