1 Computer Drive South

Albany, NY 12205

518-459-6612518-459-69614(fax)

PAY CARD

Instructions

Effective February 19, 2015 The Nurse Connection Staffing, Inc. will begin utilizing Skylight Financial Pay Cards (Debt Card) for Weekly Payroll funds and/or Pay Advance Funds.

To elect use of the Pay Card, each individual must complete a Pay Card Authorization form (see attached).

  • You may elect to have just onlyPay Advance and Mileage Reimbursement funds transferred to your Pay Card
  • You may elect to have allPayroll, Mileage Reimbursement and Pay Advance funds transferred to your Pay Card.
  • In order to receive a pay advance or Mileage Reimbursement, you must have a pay card.
  • If you elect to have a direct deposit to your personal bank or credit union, please be advised Pay Advance funds can only be transferred to a Pay Card Account and not your personal bank or credit union.
  • If you elect to have a paper Payroll check mailed to your home address, please be advised Pay Advance and/or Mileage Reimbursement funds cannot be sent by check. You can only receive pay advance and mileage Rebursement funds via a pay card.
  • If your Pay Card ir lost or stolen, please inform the Nurse Connection Staffing Payroll Department immediately.

To sign up for a pay card, complete the form on the next page, sign and return to the office by mail, fax (518-459-6614) or scan/email to .

Nurse Connection Staffing, Inc.

PAY CARD REQUEST/AUTHORIZATION FORM

Name:______

Account # of Pay Card:______

Note: If you are signing up and you are not at our office, you do not need to include the account number of the pay card. We will complete this when we receive this form.

  • This number I found on the front of the introductory letter that has your pay card attached to it. Your account number is not the number on your pay card itself

Please select one:

______Pay card will be used for Pay Advance and Mileage reimbursement funds only.

(This is MANDATORY)

______Pay card will be used for all Pay Advance, Mileage Reimbursement and weekly

Payroll funds.

I hereby authorize The Nurse Connection Staffing, Inc. to transfer Pay Advance, Mileage Reimbursement and/or Weekly payroll funds onto my Skylight Financial Pay Card (debt card).

______

Print NameDate

______

Signature

What happens next?

  • Once your request is received in our office, we will establish your pay card account and mail the card package to the address we have on file. If you have changed your address, you must inform the office.
  • When you receive the pay card, you must activate it on line or by phone (see the instructions in the package). Once activated, you can use immediately.

If you need a card right away and don’t want to wait for the mail …

Come to the office during our business hours 7:00 am – 3:30 pm Monday – Friday. For Central & Western NY, call our office (518-459-6612) before going to the office in Liverpool (Syracuse).

Pay Card Authorization

Revised 11. 20.15 DM