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H&R Block Bank

 
Which form do I choose?
To decide which form you need, first select the option below that best describes your account.

I put my tax refund on a MasterCard®.
H&R Block Emerald Prepaid MasterCard®
Did you activate an H&R Block Emerald Prepaid MasterCard® at your local H&R Block tax office? Please use the following forms to service your Emerald Card account with us.

Form: Change of Address

Purpose: This form should be used to change the address, phone number or e-mail address on accounts held with the H&R Block Bank.



Form: Emerald Card Transfer Request

Purpose: For transferring funds from an H&R Block Emerald Prepaid MasterCard® to another H&R Block Emerald Prepaid MasterCard®, or another financial institution.
I opened a savings account or an IRA in an H&R Block tax office.
H&R Block Easy Products
If you opened an H&R Block Easy IRA and/or H&R Block Easy Savings account through your local H&R Block Tax office or online, please use the following links for additional product-specific forms to prevent any possible delay in processing.
  • H&R Block Easy Savings Forms
  • H&R Block Easy IRA Forms
I have an H&R Block Bank checking, savings, money market, retirement or certificate of deposit account.
H&R Block Bank
If you opened an H&R Block Bank checking, savings, money market, retirement or certificate of deposit account using the Bank Web site or via a visit to our branch, please use the product-specific forms linked below to prevent any possible delay in processing.

General Forms
Form: Affidavit of Domicile

Purpose: This affidavit is required to establish an estate account or transfer assets held in the name of a decedent to another account held at the H&R Block Bank when:
  • The account holder of an individual account is deceased.
  • One or both account holders of a joint account are deceased.

The form must be filled in and signed before a notary.



Form: Interested Party

Purpose: This form should be used to designate interested parties to be added to or removed from your account(s). You can authorize interested parties to make phone inquiries on your account or to receive a duplicate copy of your statements.

This form will not grant Power of Attorney and does not provide authority to request distributions from an account.



Form: Power of Attorney

Purpose: This Power of Attorney certification form is required to grant an individual Power of Attorney over one or more accounts held with the H&R Block Bank.



Deposit Forms
Form: Automatic Deposit or Withdrawal

Purpose: This form can be used to initiate a one-time or re-occurring transfer between an H&R Block Bank account and an account held at another financial institution. The same form can be used to establish a new transfer, change an existing transfer or cancel future transfers.



Form: Business Account Application

Purpose: Application to Open a Business Checking Account with H&R Block Bank.



Form: Deposit Account Application

Purpose: Application to open a Checking, Savings, Money Market or CD Account with H&R Block Bank.



Form: Deposit Slip

Purpose: For making deposits into an H&R Block Bank Checking, Savings or Money Market Account.



Form: Stop Pay Request

Purpose: For requesting that payment be stopped on an outstanding check drawn on your H&R Block Bank account.



Form: Wire Request

Purpose: For wiring funds from an H&R Block account to an account held at another financial institution.



Form: Withdrawal Slip

Purpose: For withdrawing funds from an H&R Block Bank Checking, Savings, Money Market or CD Account. (To withdrawal money from an IRA, use the IRA Disbursement Request Form).



Loan Forms
Form: Consumer Loan Application

Purpose: This form should be used to apply for an Overdraft Line of Credit attached to your H&R Block Bank checking account or a consumer loan secured by an H&R Block Bank Certificate of Deposit. If you are interested in a home mortgage or home equity loan or line of credit, please submit our Mortgage Pre-Qualification form.



Form: Direct Payment of Loan

Purpose: This form can be used to initiate a one-time or re-occurring transfer from a deposit account held at the H&R Block Bank or an external financial institution for the purpose of making payment on a loan held at the H&R Block Bank. The same form can be used to establish a new transfer, change an existing transfer or cancel future transfers.



Form: Mortgage Pre-Qualification

Purpose: The pre-qualification sheet allows the Bank to collect information necessary to provide you with specific home financing alternatives.



IRA Forms
Form: IRA Rollover

Purpose: The Request for Direct Rollover to a Traditional IRA form is designed to assist you in moving assets from your eligible retirement plan to your traditional individual retirement account (IRA).



Form: Change of Beneficiary

Purpose: The IRA Designation or Change of Beneficiary Form for Traditional, Roth, and SIMPLE IRAs is designed to assist you in selecting or changing the current beneficiary designation of your individual retirement account (IRA).



Form: Roth IRA Application

Purpose: This form contains all the necessary steps to establish a Roth individual retirement account (IRA).



Form: Traditional IRA Application

Purpose: This form contains all the necessary steps to establish a traditional individual retirement account (IRA).
I want to see all available forms.
H&R Block Emerald Prepaid MasterCard®
Did you activate an H&R Block Emerald Prepaid MasterCard® at your local H&R Block tax office? Please use the following forms to service your Emerald Card account with us.

Form: Change of Address

Purpose: This form should be used to change the address, phone number or e-mail address on accounts held with the H&R Block Bank.



H&R Block Emerald Advance Line of Credit
Please use the following forms to service your Emerald Advance Line of Credit with us.

Form: Emerald Advance Auto-Pay Request Form

Purpose: This form should be used to authorize H&R Block Bank to automatically debit your Emerald Card each month for the minimum payment amount due on your Emerald Advance. You will need to be certain that your Emerald Card available balance is sufficient to cover the minimum payment to be transferred each month.



Form: Emerald Card Transfer Request

Purpose: For transferring funds from an H&R Block Emerald Prepaid MasterCard® to another H&R Block Emerald Prepaid MasterCard®, or another financial institution.



H&R Block Easy Products
If you opened an H&R Block Easy IRA and/or H&R Block Easy Savings account through your local H&R Block Tax office or online, please use the following links for additional product-specific forms to prevent any possible delay in processing.
  • H&R Block Easy Savings Forms
  • H&R Block Easy IRA Forms




H&R Block Bank
If you opened an H&R Block Bank checking, savings, money market, retirement or certificate of deposit account using the Bank Web site or via a visit to our branch, please use the product-specific forms linked below to prevent any possible delay in processing.

General Forms
Form: Affidavit of Domicile

Purpose: This affidavit is required to establish an estate account or transfer assets held in the name of a decedent to another account held at the H&R Block Bank when:
  • The account holder of an individual account is deceased.
  • One or both account holders of a joint account are deceased.

The form must be filled in and signed before a notary.



Form: Interested Party

Purpose: This form should be used to designate interested parties to be added to or removed from your account(s). You can authorize interested parties to make phone inquiries on your account or to receive a duplicate copy of your statements.

This form will not grant Power of Attorney and does not provide authority to request distributions from an account.



Form: Power of Attorney

Purpose: This Power of Attorney certification form is required to grant an individual Power of Attorney over one or more accounts held with the H&R Block Bank.



Deposit Forms
Form: Automatic Deposit or Withdrawal

Purpose: This form can be used to initiate a one-time or re-occurring transfer between an H&R Block Bank account and an account held at another financial institution. The same form can be used to establish a new transfer, change an existing transfer or cancel future transfers.



Form: Business Account Application

Purpose: Application to Open a Business Checking Account with H&R Block Bank.



Form: Deposit Account Application

Purpose: Application to open a Checking, Savings, Money Market or CD Account with H&R Block Bank.



Form: Deposit Slip

Purpose: For making deposits into an H&R Block Bank Checking, Savings or Money Market Account.



Form: Stop Pay Request

Purpose: For requesting that payment be stopped on an outstanding check drawn on your H&R Block Bank account.



Form: Wire Request

Purpose: For wiring funds from an H&R Block account to an account held at another financial institution.



Form: Withdrawal Slip

Purpose: For withdrawing funds from an H&R Block Bank Checking, Savings, Money Market or CD Account. (To withdrawal money from an IRA, use the IRA Disbursement Request Form).



Loan Forms
Form: Consumer Loan Application

Purpose: This form should be used to apply for an Overdraft Line of Credit attached to your H&R Block Bank checking account or a consumer loan secured by an H&R Block Bank Certificate of Deposit. If you are interested in a home mortgage or home equity loan or line of credit, please submit our Mortgage Pre-Qualification form.



Form: Direct Payment of Loan

Purpose: This form can be used to initiate a one-time or re-occurring transfer from a deposit account held at the H&R Block Bank or an external financial institution for the purpose of making payment on a loan held at the H&R Block Bank. The same form can be used to establish a new transfer, change an existing transfer or cancel future transfers.



Form: Mortgage Pre-Qualification

Purpose: The pre-qualification sheet allows the Bank to collect information necessary to provide you with specific home financing alternatives.



IRA Forms
Form: IRA Rollover

Purpose: The Request for Direct Rollover to a Traditional IRA form is designed to assist you in moving assets from your eligible retirement plan to your traditional individual retirement account (IRA).



Form: Change of Beneficiary

Purpose: The IRA Designation or Change of Beneficiary Form for Traditional, Roth, and SIMPLE IRAs is designed to assist you in selecting or changing the current beneficiary designation of your individual retirement account (IRA).



Form: Roth IRA Application

Purpose: This form contains all the necessary steps to establish a Roth individual retirement account (IRA).



Form: Traditional IRA Application

Purpose: This form contains all the necessary steps to establish a traditional individual retirement account (IRA).
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  • NOTICE OF CHANGES IN TEMPORARY FDIC INSURANCE
    COVERAGE FOR TRANSACTION ACCOUNTS

    All funds in a "noninterest-bearing transaction account" are insured in full by the Federal Deposit Insurance Corporation from December 31, 2010, through December 31, 2012. This temporary unlimited coverage is in addition to, and separate from, the coverage of at least $250,000 available to depositors under the FDIC's general deposit insurance rules.

    The term "noninterest-bearing transaction account" includes a traditional checking account or demand deposit account on which the insured depository institution pays no interest. It also includes Interest on Lawyers Trust Accounts ("IOLTAs"). It does not include other accounts, such as traditional checking or demand deposit accounts that may earn interest, NOW accounts, and money-market deposit accounts.

    For more information about temporary FDIC insurance coverage of transaction accounts, visit www.fdic.gov.