Comdata Consent form - Prime Total Rewards 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by selecting the type of request you are making: New Card, Replacement Card, Temp Card (Final Pay), or Temp Card (Missed Pay). Check the appropriate box.
  3. In the 'Print Name' field, enter your first and last name clearly.
  4. Fill in your home address, including street, city, state, and zip code. This will be used for payroll records.
  5. Enter your card number in the designated field. Ensure all digits are filled before submitting to Payroll.
  6. Use your Employee Number as your Activation Code in the specified area.
  7. Sign and date the form at the bottom. Make sure to print your name again for clarity.
  8. Lastly, provide any additional information required such as Loc Name/Number and Last 4 Digits of SSN.

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