Please complete this form for your Qualified Bank Fee Reimbursement Requests.
You may complete the form electronically, by clicking here.
Or you can download and complete the form, by clicking here.
All forms must be submitted to PayData Fianance
Email: Finance@paydata.com
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.