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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

*First Name:    MI:  
*Last Name: 
  Business Name:
*Mailing Address:
  Street Address: (if different)
*Home Phone:
  Work Phone:
  Cell Phone:
*Email Address:
*Re-enter Email Address:
*Primary Accountholder:
Last four of Social Security Number
or Tax I.D. Number
 Account Number(s):


In order to use State Exchange Bank's Online Banking, you agree to the following information along with the terms and conditions:

By entering the confirmation code below, I certify that the information provided is true and correct. I authorize State Exchange 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 State Exchange Banks's Disclosure Agreement and I agree to the terms and conditions.

*Confirmation Code:

(To complete your enrollment in Online Banking, you must click on the State Exchange Bank Disclosure button below to receive a confirmation code.)


To complete your enrollment in Online Banking, you must click on the State Exchange Bank's Disclosure Agreement Link below to receive a confirmation code.

State Exchange Bank Disclosure Agreement

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

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