Comdata Consent form - Prime Total Rewards 2025

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  1. Click ‘Get Form’ to open the Comdata Consent form in the editor.
  2. Select the type of request you are making by checking one of the boxes: New Card, Replacement Card, Temp Card (Final Pay), or Temp Card (Missed Pay).
  3. Fill in your full name in the 'Print Name' field, ensuring it is clear and legible.
  4. Provide 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 out correctly before submission.
  6. Use your Employee Number as your Activation Code in the appropriate section.
  7. Sign and date the form at the bottom to confirm your consent for electronic wage transfer to your Comdata card.
  8. Complete any additional fields such as Loc Name/Number, Last 4 Digits SSN, Employee ID, and Date of Birth as required.

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