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Forms

These forms are being provided for your convenience. The forms are in printable formats and may be faxed to the number on the form or mailed to us at: 

Hilliard Lyons Private Banking
409 Silverside Road, Suite 105
Wilmington, DE 19809

If you have any questions, please call us at 877.644.1513.

ACH Loan Payment Authorization Form
Complete this form to authorize the Bank to electronically transfer funds through the Automated Clearing House (ACH) system from your deposit account at another financial institution to the Bank in payment of a loan.

Affidavit of Unauthorized ACH
This form will allow a customer to dispute an Automated Clearing House transaction on their account. Please complete the form, sign and submit to the Bank for further processing through mail or by faxing to the number provided on the form.

Affidavit of Forged or Altered Check
This form will allow a customer to dispute that a check drawn from his/her account was either Forged or Altered. Please complete the form, sign before a Notary Public, and submit to The Bancorp Bank via mail for further processing. 

Change of Contact Information
This form can be used to update your name, e-mail address, telephone number, and home address information.

Interest Capitalization Form
Use this form to request or terminate automatic advances of monthly interest payments from a securities-backed line of credit.

Request to Add or Change Third-Party Statement Recipient
This form will allow you to add or update information regarding the third parties that receive copies of your statements.

Resolution for Facsimile
This form will allow a signer on an account to use a stamp on checks and other documents for their signature instead of hand signing the document. A color stamp must be used to deter fraud. Please print, hand sign, facsimile stamp the form and submit to the Bank for further processing. Facsimile signatures will not be accepted by us without this completed form.

Stop Payment
This form allows for a customer to stop the payment of a check or ACH on an account. Please call the toll-free number listed in the customer service tab to place the stop payment. A stop payment is only valid for 14 days without this signed and submitted form. Once the form is received by the Bank the stop payment will be valid for 6 months. 

Treasurer's Check Request Form For Securities-Backed Line of Credit
Use this form to request a Treasurer’s Check from your securities-backed line of credit with the Bank.

Trustee Certification/Affidavit for Securities-Backed Line of Credit
Use this form when applying for a Securities-Backed Line of Credit for a Trust.

Wire Request Form for Securities Backed Line of Credit (Domestic & International)
Complete this form to make a one-time electronic wire transfer by advancing funds from your Securities Backed Line of Credit with the Bank to a beneficiary’s account.