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Sign Up for Internet Banking

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 call you to confirm your request for an on-line account during normal business hours, often the same day.

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:

*Account Numbers:

(Please list the account numbers that you currently have. If your Checking Account and Savings Account currently appear on the same statement, both accounts must be listed)

*1	4	7
2	5	8
3	6	9

By entering the confirmation code below, I certify that the information provided is true and correct. I authorize Farmers Savings Bank to verify the information on this enrollment form and allow access to all accounts listed above of which I am an owner. I further certify that I have read the Farmers Savings Bank Disclosure and I agree to the terms and conditions.

*Confirmation Code:

(To complete your internet banking enrollment, you must click on the Farmers Savings Bank Internet Banking Agreement and Disclosure link below to receive a confirmation code.)

*REQUIRED Entries

To complete your enrollment for Internet Banking, you must click on the Farmers Savings Bank Internet Banking Agreement and Disclosure Link below to receive a confirmation code. Once you have the confirmation code, enter it in the field above in order to submit this application

Farmers Savings Bank Internet Banking Agreement and Disclosure

You will need Adobe® Reader® in order to view the Internet Banking agreement and Disclosure. Adobe® Reader® is free software used for viewing and printing electronic forms. To download, click here or go to www.adobe.com and follow the online instructions.