Simplify Your Life. Switch to Central Bank of the Ozarks. Account Application. Address

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1 Personal Information Individual Account Holder Joint Account Holder Physical (no P.O. Box) Physical (no P.O. Box) Mailing Mailing

2 Signer Information Individual Account Holder Joint Account Holder Physical (no P.O. Box) Physical (no P.O. Box) Mailing Mailing

3 Business Information Business Information Business Physical (no P.O. Box) Mailing (If Different than physical address) Business Phone Primary Contact Primary Contact Phone Number Primary Contact Federal Tax ID Number Beneficial Owners of Business Years In Business Specific Line of Business List of Signers

4 Individual Account Holder Joint Account Holder ,, Signature of first named owner Signature of joint owner

5 Account Closing Form Previous Bank Please forward funds according to closing date to: From: Primary Account Holder s Primary Social Security Number Secondary Account Holder s Central Bank of the Ozarks Attn: c/o: PO Box 3397 Springfield, Mo (customer name) (customer name) Please close the following accounts Account Type Account Number* Check Here to send payment immediately* Special Instructions I authorize you to close the accounts listed above and to forward funds to Central Bank of the Ozarks. Primary Account Holder Signature Secondary Account Holder Signature Date *Please make sure all checks and all automatic debits have been switched prior to closing your account. We recommend viewing two months statements to ensure you have switched them all.

6 Automatic Payment Switch Form Merchant or Utility Merchant or utility account number From: Customer Financial Information Please redirect my automatic withdrawal from my old account: Bank Account No. Routing No. To be withdrawn from new account at Central Bank of the Ozarks: Account No. Routing No Amount of withdrawal Effective Date I, (print name), authorize you to redirect payment from my old account to my new account effective. If you have questions, please contact me at the following phone number. Authorized signature Date Please complete a new form for each automatic withdrawal you are switching. To save time and money, stop by any Central Bank of the Ozarks location for assistance in completing your forms. We will make it simple by completing the switch and mailing the forms to the address you listed, postage is on us! Thank you for choosing Central Bank of the Ozarks.

7 Authorization to Change Direct Deposit To: Company Company Attn: From Employee I.D. Home Employee Department Home phone I authorize you to change my Payroll direct deposit to my new Central Bank of the Ozarks account effective beginning (please allow 3 to 4 weeks). (Date) Current Direct Deposit Old Financial Institutions Account Number Routing Number Amount Redirect my direct deposit to: Old Financial Institutions Account Number Routing Number Amount Authorized signature Date

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