On-Line Banking Application
To sign up for On-line Banking, complete this application
and fax it to 630-871-9690. For more information, call 630-871-9711. (Please do not e-mail confidential information.)
Once we've verified your application, we will provide you with a temporary password. At your first sign on, you will be asked to select a new password. Passwords must be 8-17 characters, at least 2 of which must be numeric.
Customer
Information
Name________________________________________Birthdate____________________
Address___________________________City,
State, Zip__________________________
Email Address_________________________________Phone______________________
USERID (6-10
Characters):______________________________________________________
SECURITY
PASSWORD (Please select a unique word or phrase that we can use to
verify your identity):
_________________________________________________________________________
Authorization
Please enroll
me in Winfield Community Bank’s On-Line Banking service. I state
that I have full authority to sign this application and that
my signature is consistent with the signature arrangement set forth
in deposit documents listed for each account accessed. I agree
to defend, indemnify, and hold Winfield Community Bank harmless from
any misuse, or unauthorized access to Winfield Community Bank On-Line
Banking service conducted on my behalf. By signing this application
and using the services, I am subject to fees, terms and conditions
contained in the Winfield Community Bank On-Line Banking Agreement
and other documents provided to me about Winfield Community Bank On-Line
Banking, I authorize all of the online banking and bill payment
transactions to or from my accounts that are established through Winfield
Community Bank On-Line Banking and acknowledge that I authorize these
transactions by entering my password, personal identification number
(PIN) or authorization code and providing the necessary instructions
through Winfield Community Bank On-Line Banking. Winfield Community
Bank is authorized to debit my designated accounts for all bill payments
that I establish through On-Line Banking and all fees and charges
that I incur in connection with Winfield Community Bank On-Line Banking.
Signature__________________________________Date_____________
