SWITCH KIT. OSB Routing Number: New OSB Account Number:

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2 SWITCH KIT Account Type: Checking Savings OSB Routing Number: New OSB Account Number: 417 S. Main St.. You may contact us by phone at or Your new account contact is:. Use the tables below to list your automatic deposits and/or deductions: Automatic Deposits* Date Company Name Account Number Deposit Amount Automatic Deductions** Date Company Name Account Number Deduction Amount Your previous account number and routing number are: Former Financial Institutions name: Former Account Number: Former Routing Number: *Automatic Deposits are recurring deposits automatically deposited into your account (ex: payroll checks, social security, etc.) from accounts outside of. **Automatic Deductions are recurring payments withdrawn from your account (ex:mortgage payments, insurance premiums, etc.)

3 SWITCH KIT-DEPOSITS AUTOMATIC DEPOSITS You must complete a separate form for each recurring deposit. Please note that some companies may require you to fill out separate forms specific to them. Company Name: Company Address: To Whom It May Concern; I recently changed banks and am requesting that my automatic deposit be transferred to my new account at. My Information is as follows: Name as it appears on your records: Account Number as it appears on your records: Amount of Current Deposit:$ My Address: My Phone Number: Please switch my automatic deposit to my: Checking Savings Account Number: 417 S. Main St Routing Number: Effective: Immediately On / / I hereby authorize the above listed company to initiate deposits of funds to my account. It is agreed that these deposits and adjustments may be made electronically and under the Rules of the National Automated Clearing House Association. This authorization will remain in effect until I send written notice to cancel. It is understood that any such payments so forwarded to which I am not entitled shall be returned to the extent there are funds in my account(s). Signature:

4 SWITCH KIT-DEDUCTIONS AUTOMATIC DEDUCTIONS You must complete a separate form for each company that processes an automatic withdrawl from your account. Please note that some companies may require that you fill out separate forms specific to them. COMPANY NAME: COMPANY ADDRESS: To Whom It May Concern; I recently changed banks and am requesting that my automatic deduction be switched to my new account at. My information is as follows: Name as it appears on your records: Account number as it appears on your records: Amount of Current Deduction/Payment:$ My Address: My Phone number: Please switch my automatic deductions to this account: Checking Savings Account Number: Routing Number: Effective: Immediately On / / 417 S. Main St I hereby authorize the above listed company to initiate withdrawls of funds from my account. It is agreed that these withdrawls and adjustments may be made electronically and under the Rules of the National Automated Clearing House Association. This authorization will remain in effect until I send written notice to cancel. Signature:

5 SWITCH KIT-CLOSING ACCOUNT CLOSING YOUR OLD ACCOUNT You must complete a separate form for each account you want to close. Send this form after you have confirmed ALL activity has cleared and ALL recurring deposits and deductions have been switched to OSB Community Bank. Former Bank Name: Name of Primary Account Holder Name of Secondary Account Holder Address: Phone: To Whom It May Concern: Please close my bank account as described below Immediately On / / Name on Account: Account Number Checking Savings Money Market Please send the balance of this account by: Official Check Wire Transfer t ACH to: My account via wire transfer Attn: Tellers to routing number ( account number) If you have any questions, please contact me at. Signature: Signature: or

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