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Personal Account Setup

ADA Card

Please provide the following information so that we can create a login for your online account.

Cardholders Personal Email *

Please use the email address that you use most often. This will be your personal login to your account so do not use an email address that you share with others.

Confirm Cardholders Personal Email *

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Mobile Phone Number *

Used to keep your account safe from fraud

Last 4 digits of your credit card number *

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Last 4 digits of your SSN/Tax ID *

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