Please complete this form for your Qualified Bank Fee Reimbursement Requests.
All forms must be submitted to PayData Fianance
Fax to: PayData Finance – 802.338.5514
Conditions for PayData’s Qualified Bank Fee Reimbursements are:
- More than four QBFRs require an additional submission or form.
- All PayData correspondence will be done with the employer. PayData will not respond to employees.
- PayData reserves the right to confirm all QBFRs.
- QBFRs are only available to employees impacted by the delayed direct deposit event of 10.24.19.
- QBFRs require supporting documents or images and must include name, date, fee description, and amount of fee.
- Account numbers are NOT required – Please Do Not Send.
- QBFRs bank fees must be dated between 10.24.19 and 10.28.19, and must be submitted to PayData before 1.1.2020.
- PayData will process the QBFR forms within 30 days of submission. Please monitor your account.
- The total QBFR amount will be deposited to the employee’s bank listed on the QBFR.