OnLine Banking Appication 1st Name: SSN/Tax ID #: Work Phone: City born in: Fax: Mother's Maiden Name: Emai Address: 2nd Name: SSN/ax ID#: Work Phone: City born in: Fax: Mother's Maiden Name: Emai Address: Other Info Home Address: City, State, Zip: Home Phone: Daytime Phone: Main Checking/Savings Acct #: Business Name (ony if business account): To Cance: I understand that access LRB's OnLine Bank products are an ongoing access & that withdraw access I need inform LRB of my wishes in writing Transfers: I hereby authorize LRB aow me transfer funds between any accounts of which I am an owner These transfers wi be initiated by my use of a password through LRB's OnLine Bank systems on either a recurring or nonrecurring frequency Eectronic Bi Payments (OnLine Bank ony): I hereby authorize LRB debit my checking account(s) for the amount and frequency as entered through LRB's OnLine Bank product These bi payment requests wi be competed ony for accounts which aow such transactions and which have adequate funds compete the requested transaction These transactions wi be initiated by my use of a password through LRB's OnLine Bank system on either a recurring or nonrecurring frequency I understand there is a fee of $50 per bi pay & this wi be deducted from the originating account Passwords: I understand I wi be assigned a password now & wi be prompted for a new password the first time I enter OnLine Bank I shoud not share these with anyone By signing beow I acknowedge that I have received the Eectronic Funds Transfers Notice Signature: Signature: Signature: Bank Use: Opened by: Port #: Date: Date Date 51 Main Street PO Box 62 1690 1 st Street South PO Box 450 Sunburg, MN 56289 PO Box 1740 New London, MN 56273 320 366 3885 Wimar, MN 56201 320 354 2011 320 235 5900 F:\Users\Kristi\Marketing\OnLine Banking\OnLine Appicationdoc wwwakeregioncom
ESTATEMENT APPLICATION OnLine User: Yes No 1 st Name SSN Current Phone # Emai Address: Acct # Do you wish continue receiving notices when your Ready Reserve advances? (These wi continue come via reguar mai) ESTATEMENT INSTRUCTIONS: 1 You wi need have OnLine Banking 2 To receive EStatements, you wi need Adobe Acrobat reader version 60 or greater on your computer If you do not have that, you can go adobecom get it downoaded for free 3 A accounts must be truncated 4 Fi out the appication and return it the bank 5 When your statements are ready, you wi get an EStatement notification via emai Notification of EStatements wi be sent the emai stated above If your emai changes, pease notify the bank immediatey ensure continuation of your EStatements By signing beow, I acknowedge I have received the Eectronic (Reg E) Notice and I am a current OnLine banking cusmer Signature Date Signature Date Bank Use: Opened by: Port: Input Done Output Done 51 Main Street PO Box 62 1690 1 st Street South PO Box 450 Sunburg, MN 56289 PO Box 1740 New London, MN 56273 320 366 3885 Wimar, MN 56201 320 354 2011 320 235 5900 F:\Users\Kristi\Marketing\OnLine Banking\OnLine Appicationdoc wwwakeregioncom
ELECTRONIC FUND TRANSFERS YOUR RIGHTS AND RESPONSIBILITIES The Eectronic Fund Transfers we are capabe of handing for consumers are indicated beow, some of which may not appy your account Some of these may not be avaiabe at a terminas Pease read this discosure carefuy because it tes you your rights and obigations for these transactions You shoud keep this notice for future reference TYPES OF TRANSFERS, FREQUENCY AND DOLLAR LIMITATIONS (a) Prearranged Transfers Preauthorized credits You may make arrangements for certain direct deposits be accepted in your X X (b) Teephone Transfers You may access your account(s) by teephone at using a uch ne phone, your account numbers, and : X (c) ATM Transfers You may access your account(s) by ATM using your MasterCard Debit/ATM card and persona identification number : Make deposits checking accounts Make deposits savings accounts Get cash withdrawas from checking accounts you may withdraw no more than per day Get cash withdrawas from savings accounts you may withdraw no more than per day Transfer funds from savings checking Transfer funds from checking savings Transfer funds from checking checking Make payments from checking account checking and/or savings account(s) Preauthorized payments You may make arrangements pay certain recurring bis from your checking and/or savings account(s) Transfer funds from checking savings Transfer funds from savings checking Transfer funds from Transfer funds from Make payments from checking oan accounts with us Make payments from Make payments from Get checking account(s) information Get savings account(s) information Make payments from (d) PointOfSae Transactions Using your card: You may access your checking account account(s) purchase X X X goods ( in person, by phone, by computer), pay for services ( in person, by phone, by computer), get cash from a merchant, if the merchant permits, or from a participating financia institution, and do anything that a participating merchant wi accept You may not exceed more than $ in transactions per day May not exceed more than $ in sig based trans per day (e) Computer Transfers You may access your account(s) by computer by ogging in our website at wwwakeregioncom access our OnLine Banking Program and using your Access ID and Password : Transfer funds from checking savings Transfer funds from savings checking Transfer funds from checking checking Transfer funds from savings savings Make payments from checking oan accounts with us Make payments from savings Loan Accounts Make payments from checking a third party Get checking account(s) information Get savings account(s) information X Get oan information Get checking account(s) information Get savings account(s) information Or as agreed upon by both parties during the ife of the account Get CD information (f) Mobie Banking Transfers You may access your account(s) by webenabed ce phone by enroing in our Mobie Banking program and using your password : Woters Bankers Eectronic Kuwer Systems Fund Transfers ETM2LAZMN 10/18/2014 Financia VMP, DiscosureMN Page 1 of 5
Transfer funds from checking savings Transfer funds from savings checking Transfer funds from checking checking Transfer funds from savings savings Make payments from checking oan accounts with us Make payments from Make payments from Get checking account(s) information Get savings account(s) information Get oan information Get CD information Eectronic check conversion You may authorize a merchant or other payee make a onetime eectronic payment from your checking account using information from your check pay for purchases or pay bis You may: Not exceed more than by eectronic check per payments Make payments by eectronic check from Payments are imited per Eectronic returned check charge You may authorize a merchant or other payee initiate an eectronic fund transfer coect a charge in the event a check is returned for insufficient funds You may: Make no more than per payments for eectronic payment of charges for checks returned for insufficient funds Make eectronic payment of charges for checks returned for insufficient funds from Payments are imited per You may be charged access fees by your ce phone provider based on your individua pan Web access is needed use this service Check with your ce phone provider for detais on specific fees and charges X (g) Eectronic Fund Transfers Initiated By Third Parties You may authorize a third party initiate eectronic fund transfers between your account and the third party's account These transfers make or receive payment may be onetime occurrences or may recur as directed by you These transfers may use the Aumated Cearing House (ACH) or other payments network Your authorization the third party make these transfers can occur in a number of ways For exampe, your authorization convert a check an eectronic fund transfer or eectronicay pay a returned check charge can occur when a merchant provides you with notice and you go forward with the transaction (typicay, at the point of purchase, a merchant wi post a sign and print the notice on a receipt) In a cases, these third party transfers wi require you provide the third party with your account number and financia institution information This information can be found on your check as we as on a deposit or withdrawa sip Thus, you shoud ony provide your financia institution and account information (whether over the phone, the Internet, or via some other method) trusted third parties whom you have authorized initiate these eectronic fund transfers Exampes of these transfers incude, but are not imited : GENERAL LIMITATIONS In addition those imitations on transfers esewhere described, if any, the foowing imitations appy: Transfers or withdrawas from a savings FEES account another account of yours or a third party by means of a preauthorized or aumatic transfer or teephone order or instruction, computer transfer, or by check, draft, debit card or simiar order a third party, are imited 6 per caendar month or statement cyce of at east 4 weeks If you exceed the transfer imitations set forth above, your account sha be subject cosure We charge are set up use each our cusmers whose accounts Woters Bankers Eectronic Kuwer Systems Fund Transfers Financia VMP DiscosureMN, ETM2LAZMN 10/18/2014 Page 2 of 5
We charge each but ony if the baance in the fas beow during the Pease refer our fee discosure and the specific account Except as indicated above, we do not charge for Eectronic Fund Transfers ATM Operar/Network Fees: When you use an ATM not owned by us, you may be charged a fee by the ATM operar or any network used (and you may be charged a fee for a baance inquiry even if you do not compete a fund transfer) DOCUMENTATION (a) Termina Transfers You can get a receipt at the time you make a transfer or from your account using a(n) aumated teer machine pointofsae termina You may not get a receipt if the amount of the transfer is $15 or ess (b) Preauthorized Credits If you have arranged have direct deposits made your account at east once every 60 days from the same person or company, you can ca us at the teephone number isted at the end of this document find out whether or not the deposit has been made (c) In addition, You wi get a monthy account statement from us, uness there are no transfers in a particuar month In any case you wi get a statement at east quartery You wi get a quartery statement from us on your savings account if the ony possibe eectronic transfer or from the account is a preauthorized credit If you bring your passbook us, we wi record any eectronic deposits that were made your account since the ast time you brought in your passbook discosure regarding fees that may appy these eectronic fund transfers TIME NEEDED TO COMPLETE TERMINAL TRANSACTIONS } Withdrawas made at a termina wi normay be competed and charged your account immediatey } Deposits made at a termina wi normay be credited your account the next business day } Transfers between accounts wi normay be competed the next business day } Payments made at a termina wi normay be competed REVERSAL OF POINTOFSALE TRANSACTIONS You cannot reverse a pointofsae transaction You can reverse a pointofsae transaction by Payment for goods or services in this manner sha not affect any of the rights, protections, or iabiities in existing aw concerning a cash or credit sae made by means other than through the use of a termina PREAUTHORIZED PAYMENTS (a) Right sp payment and procedure for doing so If you have d us in advance make reguar payments out of your account, you can sp any of these payments Here's how: Ca or write us at the teephone number or address isted in this discosure, in time for us receive your request 3 business days or more before the payment is schedued be made If you ca, we may aso require you put your request in writing and get it us within 14 days after you ca We charge $25 for each sp payment (b) Notice of varying amounts If these reguar payments may vary in amount, the person you are going pay wi te you, 10 days before each payment, when it wi be made and how much it wi be (You may choose instead get this notice ony when the payment woud differ by more than a certain amount from the previous payment, or when the amount woud fa outside certain imits that you set) (c) Liabiity for faiure sp payment of preauthorized transfer If you order us sp one of these payments 3 business days or more before the transfer is schedued, and we do not do so, we wi be iabe for your osses or damages FINANCIAL INSTITUTION'S LIABILITY Liabiity for faiure make transfers If we do not compete a transfer or from your account on time or in the correct amount according our agreement with you, we wi be iabe for your osses or damages However, there are some exceptions We wi not be iabe, for instance: } If, through no faut of ours, you do not have enough money in your account make the transfer } If the transfer woud go over the credit imit on your overdraft ine } If the aumated teer machine where you are making the transfer does not have enough cash } If the termina or system was not working propery and you knew about the breakdown when you started the transfer } If circumstances beyond our contro (such as fire or food) prevent the transfer, despite reasonabe precautions that we have taken } There may be other exceptions stated in our agreement with you CONFIDENTIALITY We wi discose information third parties about your account or the transfers you make: (1) (2) where it is necessary for competing transfers; or in order verify the existence and condition of your account for a third party, such as a credit bureau or merchant; or Woters Bankers Eectronic Kuwer Systems Fund Transfers Financia VMP DiscosureMN, ETM2LAZMN 10/18/2014 Page 3 of 5
(3) in order compy with government agency or court orders; or (4) if you give us written permission as expained in the separate Privacy Discosure UNAUTHORIZED TRANSFERS (a) Consumer Liabiity Te us at once if you beieve your card and/or code has been ost or sen, or if you beieve that an eectronic fund transfer has been made without your permission using information from your check Teephoning is the best way of keeping your possibe osses down You coud ose a of the money in your account (pus your maximum ine of credit) We wi be iabe for a unauthorized transfers uness the unauthorized transfer was due the oss or theft of your card and/or code If due the oss or theft of your card and/or code, and you notify us within 60 days of when the unauthorized transfer appears on the statement you can ose no more than $50 if someone used your card and/or code without permission If you do NOT notify us within 60 days after the unauthorized transfer appears on your statement, and we prove that we coud have spped someone from using your card and/or code without your permission if you had d us within 2 days of when you discover the oss or theft of your card and/or code, you coud ose as much as $500 for unauthorized transfers that appear on the statement Aso, if your statement shows transfers that you did not make, incuding those made by card, code or other means, te us at once If you do not te us within 60 days after the statement was maied you, you may not get back any money you ost after the 60 days if we prove that we coud have spped someone from taking the money if you had d us in time If a good reason (such as a ong trip or a hospita stay) kept you from teing us, we wi extend the time periods Visa,Debit Card } Additiona Limits on Liabiity for Uness you have been grossy negigent or have engaged in fraud, you wi not be iabe for any unauthorized transactions using your ost or sen Visa card This additiona imit on iabiity does not appy ATM transactions outside of the US, ATM transactions not sent over Visa or Pus networks, or transactions using your Persona Identification Number which are not processed by Visa Visa is a registered trademark of Visa Internationa Service Association MasterCard,Debit Card } Additiona Limits on Liabiity for MasterCard Card You wi not be iabe for any unauthorized transactions using your MasterCard debit card if: (i) you can demonstrate that you have exercised reasonabe care in safeguarding your card from the risk of oss or theft, and (ii) upon becoming aware of a oss or theft, you prompty report the oss or theft us MasterCard is a registered trademark of MasterCard Internationa Incorporated (b) Contact in event of unauthorized transfer If you beieve your card and/or code has been ost or sen, ca or write us at the teephone number or address isted at the end of this discosure You shoud aso ca the number or write the address isted at the end of this discosure if you beieve a transfer has been made using the information from your check without your permission RIGHT TO BRING CIVIL ACTION You may bring a civi action against any person vioating any provision of Minnesota Statutes 4769 (governing consumer privacy and unauthorized withdrawas) If you prevai in such an action, you may recover the greater of your actua damages or $50000 You may aso be entited recover punitive damages, your court costs and reasonabe atrney's fees ERROR RESOLUTION NOTICE In Case of Errors or Questions About Your Eectronic Transfers, Ca or Write us at the teephone number or address isted beow, as soon as you can, if you think your statement or receipt is wrong or if you need more information about a transfer isted on the statement or receipt We must hear from you no ater than 60 days after we sent the FIRST statement on which the probem or error appeared (1) (2) Te us your name and account number (if any) Describe the error or the transfer you are unsure about, and expain as ceary as you can why you beieve it is an error or why you need more information Te us the doar amount of the suspected error (3) If you te us oray, we may require that you send us your compaint or question in writing within 10 business days We wi determine whether an error occurred within 10 business days (5 business days if invoving a Visa,pointofsae transaction processed by Visa or 20 business days if the transfer invoved a new account) after we hear from you and wi correct any error prompty If we need more time, however, we may take up 45 days (90 days if the transfer invoved a new account, a pointofsae transaction, or a foreigninitiated transfer) investigate your compaint or question If we decide do this, we wi credit your account within 10 business days (5 business days if invoving a Visa pointofsae transaction processed by Visa or 20 business days if the transfer invoved a new account) for the amount you think is in error, so that you wi have the use of the money during the time it takes us compete our investigation If we ask you put your compaint or question in writing and we do not receive it within 10 business days, we may not credit your account An account is considered a new account for 30 days after the first deposit is made, if you are a new cusmer We wi te you the resuts within three business days after competing our investigation If we decide that there was no error, we wi send you a written expanation You may ask for copies of the documents that we used in our investigation AMENDMENTS AND TERMINATION We reserve the right amend any terms in this discosure and terminate your card privieges upon giving written notice you within a reasonabe period of time in advance of the effective date of the amendment or termination You may terminate your card privieges by notifying us and returning your card Woters Bankers Eectronic Kuwer Systems Fund Transfers Financia VMP DiscosureMN, ETM2LAZMN 10/18/2014 Page 4 of 5
By signing beow cusmer acknowedges receipt of pages 1, 2, 3, 4 and 5 of this notice: ADDITIONAL INFORMATION: TO REPORT A LOST OR STOLEN CARD: Pease ca our financia institution directy at 18007337064 Signed Dated INSTITUTION (name, address, teephone number, business days) LAKE REGION BANK 51 MAIN ST BOX 450 NEW LONDON, MN 56273 Banking Hours are as foows (excuding Hoidays): New London Monday Thursday: 7:30am5:00pm Friday: 7:30am6:00pm Saturday: 8:00am12 noon Sunburg Monday Friday: 9:00am1:00pm Wimar MondayFriday: 8:00am6:00pm Saturday: 8:00am12 noon Advisory Against Iega Use you agree not use your MasterCard check/debit card for iega gambing or other iega purposes Dispay of a payment card ogo by, for exampe an On Line Merchant, does not necessariy mean that transactions are awfu in the jurisdiction in which you may be ocated Additiona Exceptions Financia Institutions Liabiity for Faiure Make Transfers: if through no faut of ours, your home computer does not perform correcty; If the teephone connection is interrupted Heath Savings Accounts (HSA) We permit you (as described beow) access your HSA with a card This service is offered for the convenience of managing your HSA However, eectronicay accessing your HSA, for exampe, getting additiona cash back on an HSA debit card transaction, can raise a variety of tax concerns As a resut, before eectronicay accessing your HSA, make sure you are using the correct card Aso, it is your responsibiity ensure the contributions, distributions, and other actions reated your HSA, compy with the aw, incuding federa tax aw As aways, we recommend consuting a ega or tax professiona if you have any questions about managing your HSA The terms of this discosure are intended work in conjunction with the HSA Agreement provided you earier In the event of a confict, the terms of the HSA Agreement contro You understand that your HSA is intended be used for payment of quaified medica expenses It is your responsibiity satisfy any tax iabiity resuting from use of your HSA for any purpose other than payment or reimbursement of quaified medica expenses We do not monir the purpose of any transaction or from your HSA Nor are we responsibe for ensuring your eigibiity for making contributions or ensuring withdrawas are used for payment or reimbursement of quaified medica expenses Refer your HSA Agreement for more information reating the use of your HSA Currency Conversion & Internationa Transactionswhen you use your MasterCard(R) debit card at a merchant that settes in currency other than US doars, the charge wi be converted in the US doar amount The currency conversion rate used determine the transaction amount in US doars is either a rate seected by MasterCard from the range of rates avaiabe in whoesae currency markets for the appicabe centra processing date, which rate may vary from the rate MasterCard itsef receives, or the governmentmandated rate in effect for the appicabe centra processing date, in each instance, pus or minus any adjustment determined by the issuer The conversion rate in effect on the processing date may differ from the rate in effect on the transaction date or posting date Woters Bankers Eectronic Kuwer Systems Fund Transfers Financia VMP DiscosureMN, ETM2LAZMN 10/18/2014 Page 5 of 5
Lake Region Bank Common Features Limits and fees The foowing fees may be assessed against your account and the foowing transcation imitations, if any, appy your account Repace Debit / ATM Card Cash Withdrawa at any nonlake Region Bank/Home State Bank ATM Business Debit Card Program (initia setup) Business Debit Card monthy fee Check printing Fee depends on check stye ordered Certified Check Counter Check Money Order Reissue of Money Order Trave Card Deuxe Gift Card Overdraft Charge, "Cont Overdraft Charge" assessed every 7 caendar days the account is overdrawn The categories of transactions for which an overdraft fee may be imposed are those by any of the foowing means: checks, inperson withdrawa, ATM withdrawa, Debit Card purchase, preauthorized withdrawa or other eectronic means Nonsufficient Funds NSF (per item), "Returned Item Fee" appies items Returned Overdraft Fees (per item), "Overdraft Fee" appies items Paid The categories of transactions for which the Returned Item Fee and Overdraft Fee may be imposed are those by any of the foowing means: checks, inperson withdrawa, ATM withdrawa, Debit Card purchase, preauthorized withdrawa or other eectronic means Nonsufficient Funds (daiy maximum) Deposited Checks returned unpaid Account Activity Prinut (additiona $100 for maiing) Account Research (per hour) ($2000 minimum pus stmt / check printing fee) Account Baancing Assistance (per hour) ($2000 minimum) Copy of previous statement (additiona $100 for maiing) $ 125 $ 500 $ 100 $ 2500 per card $ 1000 $ 025 $ 500 $ 1500 $ 995 $ 395 $ 2700 $ 2700 $ 2700 $ 13500 $ 400 $ 200 $ 2000 $ 2000 $ 200 Imaged Statements Printed Imaged Statement (per statement) Copy of Check(s) Paid $ 100 $ 500 Dupicate Statements $ 500 Dupicate Statements with Check Images $ 1000 per page
Account Cosure within 90 days of account opening Force ReOpen of an Account Inactive Account Fee (monthy) Checking / Savings An account is statused as inactive if for 24 months there have been no deposits or withdrawas the account The charge is assessed if the baance is ess than $20000 Teephone Transfer $ 2500 $ 1000 $ 1000 $ 100 OnLine Banking Eectronic Bi Payments (per Bi Pay items) $ 050 POP Money Transfers (per Transfer) $ 050 Sp Payment a items Sp Payment on a series of consecutive check #'s $ 2500 $ 3000 Wire Transfers Outgoing Wire Transfer (Domestic) Outgoing Wire Transfer (Internationa) Incoming Wire Transfer (Domestic) Incoming Wire Transfer (Internationa) Garnishments / Levies Indemnity Bond Ready Reserve (Annua) Foreign Curency Orders (pus foregin bank charges) Coection Items $ 2000 $ 4000 $ 1000 $ 1000 $ 5000 $ 1000 $ 2500 $ 2500 $ 2500 pus our cost NonImageabe Check Fee Night Deposit / Deposit Bags Deposit Bags with Locks Deposit Bags without Locks These fees are subject change and any notice of change wi be provided as required $ 2000 per item $ 1500 $ 500