STI

To get your new card, fill all the required fields and click Verify & Submit. Fields marked with* must be completed.
Approval of your new card account request requires passing our identification process.

Account Information

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JHook card *

Legal First Name *

Last Name *

Address Line 1 * (Street Address, No PO Box or RR)

Address Line 2 (Suite, Apartment Number, Etc.)

City *

State * (Currently we do not accept applications if you live in: Connecticut or Vermont)

Zip/Postal Code * (r.g. 33701 or 33701-4313)

Date of Birth (Must be 18 or older) * (mm/dd/yyyy)

Primary Phone Number *

Mobile Phone Number

(Your phone number will not be used for research purposes, we will only use the telephone number provided to call you regarding your SurgePays™ Card.)

Email Address *

Social Security Number / ITIN Number *

Confirm Social Security Number / ITIN Number *

* ITIN - Individual Tax Identification Number is a tax processing number issued by the IRS, similar to a Social Security Number.

By checking this box, I confirm that I have read and agree with the Cardholder Agreement, Fee Schedule and Privacy Policy.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW CARD ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens a Card Account. What this means for you: When you open a Card Account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also request a copy of your driver's license or other identifying documents.

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Account Information

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