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Please provide us with the information requested below.   After you fill out and submit this form, it will be emailed to the appropriate bank representative via SECURE email.  We will email you to confirm your request to access your account(s) during normal business hours, often the same day. This e-mail will include instructions for accessing your account, Customer I.D. and Temporary Password.
 
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT.

To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.
What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

*First Name:  Mi:
*Last Name: 
*Address Line 1:  
  Address Line 2:  
*City: *State *Zip:
*Home Phone:        
*Work Phone:        
*Email:
*Social Security Number:        
For Account(s):
*  6 
 7 
 8 
 9 
10

*REQUIRED Entries

LIABILITY

If we FAIL TO COMPLETE A TRANSFER to or from your account on time or in the correct amount according to our agreement with you, we will be liable for your losses or damages with some exceptions.  We will not be liable, for instance:  (1) If, through no fault of ours, you do not have enough money in your account to make the transfer or if the transfer would exceed the credit limit on your overdraft line, if any, (2) If the money in your account is subject to legal process or other encumbrances restricting the transfer, (3) If the terminal where you are making the EFT does not have enough cash, (4) If extenuating circumstances prevent the transfer, despite reasonable precautions we have taken, (5) If the terminal or system was not working properly and you knew about the breakdown when you started the EFT, (6) If incomplete or inaccurate information is forwarded by the United States Treasury or through an automated clearing house, or (7) There may be other exceptions in our agreement with you.

                                    ERROR RESOLUTION

In case of errors or questions about your electronic transfers.  Telephone us or write us at the number or address listed in this disclosure as soon as possible, if you think your statement or receipts are wrong or if you need more information about a transfer listed on the statement or your receipt.  We must hear from you no later than 60 days after we sent the FIRST statement on which the error or problem appeared.  You should:

(1) Tell us your name and account number (if any).

(2) Describe the error or transfer in question, and explain as clearly as you can why you believe it is an error or why you need more information.

(3) Tell us the dollar amount of the suspected error.

If you tell us orally, we may require that you send us your complaint or question in writing within 10 business days.  We will determine whether an error occurred within 10 business days (20 business days if the error involves an EFT made during the first (30) days after the first deposit to the account was made) after we hear from you and will correct any error promptly.  If we need more time, however, we may take up to 45 days (90 days if the transfer involved a point-of-sale transaction, a foreign initiated transfer or an EFT made during the first thirty (30) days after the first deposit to the account was made) to investigate your complaint or question.  If we decide to do this we will credit your account within 10 business days (20 business days if the error involves an EFT made during the first thirty (30) days after the first deposit to the account was made) for the amount you think is in error, so that you will have the use of money during the time it takes us to complete our investigation.  If we ask you to put your complaint or question in writing and we do not receive it within 10 business days, we may not credit your account.

We will tell you the results within three (3) business days after completing our investigation.  If we decide that there was no error, we will send you a written explanation.  You may ask for copies of the documents that we used in our investigation.

                        OTHER RULES APPLYING TO ELECTRONIC FUND TRANSFERS

All transfers or loan payments made before 2:45 P.M. will be credited to that business day.  After our cutoff time, it will be credited the following business day.

You are limited to balances, transfers, and loan payments to related accounts within our institution only.

TelePC is a service that the bank offers to our customers at no charge.