Genesis - Order the Genesis Account with a Mobile Banking Phone Application

Personal Information*

First Name *

Middle Name

Last Name *

Address 1 *

Address 2

City *

State

Zip Code *

Date Of Birth * (Month-Day-Year)

Contact Information*

Email Address *

Confirm Email Address *

Contact Number *

Security Information*

Username *

Password *

Password Strength

Password Confirm

Hint for a secure username

Use 6 to 60 characters. You may use letters, numbers, and special characters. Email addresses are allowed.

PIN * (4 digits)

Confirm PIN (4 digits)

Your information is secure.

Security Question *

Security Answer *

Create your own security question and answer. This is a very secure method for us to verify who you are during a customer service call.

Mobile Wallet Number*

Country Code

Mobile Number *

Alternate ID

(optional)

Use Alternate SMS

For your security, our system will send a security code via SMS to your mobile number whenever you log in from a new device. If the number you are using is not a mobile number, please provide an alternate number below that is able to receive SMS messages, and we will send the security codes to the alternate number instead.

Country Code

Alternate Mobile Number

Display Currency (currency is held in USD)

Mobile Wallet Identity Verification

I wish to have a balance greater than $500

Note: If you require a balance greater than $500 and / or need to load funds with a credit card or savings / checking account, then we will need to validate your identity. This validation is free of charge and does not affect your credit.

Upload Document for Identity Verification*

Document Type *

Front Image *

Back Image *

Optional Credit/Debit Card Load

Credit/Debit Card Loading

By adding funds to your Genesis account from your credit/debit card, you will have the ability to pay your wireless bill, send funds to another Genesis account, and make purchases at affiliated merchants. If you associate a checking or savings account with your Genesis , you may transfer your funds from the wallet to that account. If you are loading via a credit card, there is a 3.00% fee that will be added to the total amount of your load. If you are loading via a debit card, there is a $1.00 fee that will be added to the total amount of your load. Your card information will also be securely stored within your Linked Accounts making future loading of funds and purchases more convenient. Your card information will never be shared with any other entity.

Type of Card

Card Number

Name on Card

Expiration Date (MMYY)

CVV (3 or 4 digits)

Nickname for Card

Amount to Load (Max Load $5.00 until account is verified)

Decline Credit Card Load

Verify Credit/Debit Card

By agreeing to this, we will make two micro transactions from your card account. Then you can login to your secure online account or update those amounts using our data application. Upon verifying these micro transactions, you will be upgrading the maximum load from $5.00 per day to $100.00 per day. This is a secure process used to determine that this credit/debit card belongs to you.

Checking / Savings Account Load

Checking / Savings Account Loading

By adding funds to your Genesis account from your checking or savings account, you will have the ability to pay your wireless bill, send funds to another Genesis account, and make purchases at affiliated merchants. The load (and processing fee of $1.00) will be deducted from your checking / savings account upon verification of the micro payments being sent to your checking / savings account. Your checking / savings account information will never be shared with any other entity.

Add a Debit Card Account to my Mobile Wallet Account

Visa Debit

By adding a Visa Debit Card account to your Genesis account, you will be able to move funds from your Genesis account balance (quasi savings account) to your Visa Debit Card account (quasi checking account) in real-time and for FREE. You can also use funds on your Visa Debit Card to pay bills, retrieve cash from virtually any ATM around the world, and make purchases anywhere Visa Debit is accepted.

Debit Card Program Type

Number of Non-Personalized / Companion Cards

Nickname *

Govt. ID Issue State *

Govt. ID Type

Govt. ID *

Date Of Birth * (Month-Day-Year)

Govt. ID Issue Date

Govt. ID Exp. Date

Monthly Fee

Per Purchase

ATM Withdrawal*

PIN Purchase**

$0.00*

$0.00

$1.50	In Network
$2.00	Out of Network

$1.50	In Network
$2.00	Out of Network

ATM balance inquiry (In Network)

$0.75

ATM balance inquiry (Out of Network)

$2.50

Replacement Card

$10.00

Additional Fees:

ATM Decline

$0.75

*ATM Withdrawal: you may also be charged a fee/surcharge by the ATM operator or any network used to complete the transaction both In Network or Out of Network

* PIN Purchase is completed by selecting "Debit" and entering your PIN to make a purchase.

You can make a Signature Purchase at no charge by selecting "Credit" at checkout and signing for your purchase (if requested to do so by the merchant).

No overdraft/credit feature.

Your funds are eligible for FDIC insurance once registered.

For general information about prepaid accounts, visit Genesis

Find details and conditions for all fees and services inside the package, or call 800-701-0833 or visit Genesis

Billing Address Use Personal Information for Billing Address

Shipping Address Use Billing Address for Shipping

Add Companion Card(s) to My Mobile Wallet Account

Companion Card

Adding a companion card will allow you to easily send money to family and friends in real-time. Companion cards will be mailed to you and then you can ship to the intended companion member. They will have the same functionality as your primary card, as well as have their own mobile wallet account with the ability to manage their own balances. Companion cards will be mailed to you within 7-10 days and can be easily activated online when you receive them. Limit 5 per customer.

Shopping Cart

Item	Retail Price	Quantity	Amount
Physical Debit Card Price	$0.00	1	$0.00
Physical Debit Card Shipping Price	$0.00	1	$0.00
	Total

Add E-Signature

Genesis Agreement

* means the field is required.

Genesis / Visa Debit Account Enrollment

Select Country*