Debit Card Travel Access

Customer Information

  • OKFirst Name is required
  • OKMiddle Initial is required
  • OKLast Name is required
  • Social Security Number

    OKSocial Security Number is required
  • Date of Birth

    OKDate of Birth is required
  • OKEmail is required
  • OptionalOKMother's Maiden Name is required

Address Information

  • OKStreet is required
  • OKCity is required
  • OKState is required
  • OKZip is required
  • Cell/Home Phone

    OKCell/Home Phone is required
  • Work Phone

    OKWork Phone is required

Debit/ATM Card Number

  • OKPlease enter your current debit card number: is required

Request your Travel Access

  • OKTravel Location is required
  • OKDates Traveling is required
  • Your debit card has default limits to allow a maximum daily purchases and maximum daily cash withdrawals. If you need your limits changed, please use our Card Limit Increase form.

  • Will you be renting a car?

    OKWill you be renting a car? is required
  • OKName of Car Rental Company is required
  • Why do we ask? There's a lot of fraud with rental car agencies and we usually block the merchant code to protect our customers. We'll unblock the specific merchant name you provide. Please be aware Auto Rental Companies have special Mastercard(r) rules that allow them to "force post" a transaction for any amount and place your account into overdraft with little recourse to refute the charge. Make sure you understand the charges to be applied and your rental contract.

  • OptionalOKAdditional Comments is required

Security Code

  • OK is required
  • OKType your name here as your signature is required
  • OKMother's Maiden name or Account Code is required
  • This document is being secured using SSL encryption provided by your browser. Your information will be encrypted when using this form while in transit between your browser and Washington Savings Bank.