Please print and complete this form and mail to:
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North County Bank Attn: Customer Service PO Box 3427 Arlington, WA 98223 |
| General Information |
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| __________________________________ | _________________________________ | ||
| Business Name | Telephone | Fax | |
| __________________________________ | _________________________________ | ||
| Contact | Title | E-mail Address | |
| __________________________________ | _________________________________ | ||
| Business Address | City, State, Zip | ||
| __________________________________ | _________________________________ | ||
| Business Tax I.D. Number | Business Type (Sole Proprietor, Corporation, Partnership, LLC) | ||
| Account Information |
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| Please select the account numbers and account type you would like access to online: | |||
| __________________________________ | _________________________________ | ||
| Account # | (Loan, Checking, Savings) | Account # | (Loan, Checking, Savings) |
| __________________________________ | _________________________________ | ||
| Account # | (Loan, Checking, Savings) | Account # | (Loan, Checking, Savings) |
| __________________________________ | _________________________________ | ||
| Account # | (Loan, Checking, Savings) | Account # | (Loan, Checking, Savings) |
| __________________________________ | _________________________________ | ||
| Account # | (Loan, Checking, Savings) | Account # | (Loan, Checking, Savings) |
| Authorized Signatures |
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| Definitions: The words "I" and "We" mean the account owner(s) and anyone else with the authority to deposit, withdraw, or exercise control over an account. If there is more than one, then those words mean each account owner separately, and all account owners jointly. An account "owner" is one who has the present right under this agreement to withdraw funds from an account, and deal with the account in his or her own name. A person who is designated by an owner to act on that owners behalf, is not an owner, but has the authority of the owner. The owner will be bound by the acts of that representative. By submitting this application, I certify that I am an authorized signer on all of the accounts listed above. I agree to keep confidential the User ID and password that will be issued to me and that I will take appropriate security measures to protect our accounts from unauthorized use. I will read the Customer Agreement for North County Bank's Internet Banking Services. I agree to be bound by the agreement when I receive it. If I use or allow another person to use Internet Cash Management, I agree to be bound by the terms of the agreement. | |||
| __________________________________ | _________________________________ | ||
| Authorized Account Signer Name #1 (Print) | Authorized Account Signer #1 (Signature) | ||
| __________________________________ | _________________________________ | ||
| Authorized Account Signer Name #2 (Print) | Authorized Account Signer #2 (Signature) | ||
| __________________________________ | _________________________________ | ||
| Authorized Account Signer Name #3 ( Print) | Authorized Account Signer #3 (Signature) | ||
| __________________________________ | _________________________________ | ||
| Authorized Account Signer Name #4 (Print) | Authorized Account Signer #4 (Signature) | ||
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All account owners and authorized signers must sign this form. If for any reason you cannot print this form, call us at 360-659-7100 or e-mail us at debbies@northcountybank.com and we will be happy to mail a copy to you. Upon receipt of your completed enrollment form we will mail you final enrollment instructions. Thank you for banking with us! |
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