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Account Holder Information
Please submit one form per individual account owner. If you have a joint account, each account owner needs to fill out this form
Please fill in your first name. 
Please fill in your last name.
This is the card you want Savvy Savings to track and round-up savings from. The round-ups from each purchase you make on this card will add to savings!
This is the account number you want the round-up savings to be deposited into. (If you wish for savings to deposit into another person's account, please contact Customer Service at 1.866.EXTRACO (398.7226).)