Is your USAA Bank account a personal (consumer) or business account?

Personal (Consumer) AccountBusiness Account

Have you been charged an overdraft or NSF (Non-Sufficient Funds) fee on a debit card purchase at least once in the past six years that was not refunded back to you?

YesNo

Are you able to provide proof of the overdraft or NSF (Non-Sufficient Funds) fee by either providing a screen shot of the transaction or a bank statement?

YesNo

Has the account been closed either by yourself or USAA Bank due to a negative balance?

YesNo

Are you filling out the form at the request of USAA Bank or its employees?

YesNo

How did you hear about us?

Page 1 of 3

Please answer the following questions to help us determine if you are eligible to make a claim for compensation:

Page 2 of 3

To move forward, please provide the following information:

Your data privacy and security is important to us. See our Privacy Policy.

Page 1 of 3

Please answer the following questions to help us determine if you are eligible to make a claim for compensation:

Page 2 of 3

To move forward, please provide the following information: Your data privacy and security is important to us. See our Privacy Policy.

To move forward, please provide the following information:

Your data privacy and security is important to us. See our Privacy Policy.