It s the easiest way to Switch banks! 1. Open a account at any of our locations. By filling out the following forms, you will help us personalize a deposit account for you. 2. Redirect your automatic payments and deposits. We have provided simple request forms for you. 3. Balance and close your old account at your old bank with the attached Account Closure Request Form. The bank will send you any remaining balance per your instruction. rev 3/13 1
PLEASE PRINT Personal Information Name 1 Name 2 Street Address Street Address (if different) City State Zip City State Zip Mailing Address (if different) Mailing Address (if different of Birth SSN of Birth SSN Phone Number 2 nd Number - Work or Cell Phone Number 2 nd Number - Work or Cell Email Address Employer/Occupation Email Address Employer/Occupation Services Requested To assist us in identifying your current and future needs, please indicate accounts and services you currently use or would be interested in using: q Checking Account q Savings Account q Personal Loan q Internet Banking/Bill Pay q Savings/Investments q Home Loan q Debit Card q Certificate of Deposit q Home Equity Line of Credit q Telephone Banking q Safe Deposit Box q Trust Services* q Electronic Statements q Money Market Accounts q Insurance Services* Accounts can be opened at any of our offices: Newport Bellevue Alexandria 103 Churchill Dr. 164 Fairfield Ave. 7300 Alexandria Pike 572-2660 491-5510 635-0777 Highland Heights Ft. Thomas Florence 2911 Alexandria Pike 34 N. Ft. Thomas Ave. 8730 U.S. Highway 42 442-8220 442-7600 384-5420 Independence Crestview Hills 2006 Patriot Way 2774 Town Center Blvd. 363-4470 363-4490 *Trust and Insurance services are offered through our affiliated companies. 2
Deposit and Payment Checklist To make the process easier, here is a checklist to help you determine all of your direct deposits and automatic payments in order to redirect them to your new account. Direct Deposits q Payroll Direct Deposit q Government Deposits q Brokerage Deposits q Transfers from Other Bank Accounts q Child Support q Other Court ordered Deposits q Other Deposits Utility Payments q Gas q Electric q Local/Long Distance Telephone Service q Cellular Phone Service q Water q Cable or Satellite TV q Other Other Payments q Insurance q Internet Service q Loans q Mortgages q Auto Loans q Other Loans q Account Transfers to Other Bank Accounts q Child Support or Court ordered Payments 3
Account Placement Survey To help us determine which checking Account is right for you, please answer the following questions: Please check the amount that best describes your average daily balance: q $2,500 or more q $2,499 - $1,000 q $999-500 q Less than $500 Please check the items which are important to you: q Drawing interest on my checking account balance q No monthly fees q Internet Banking q Electronic Bill Payment q Secure Electronic Statements q Unlimited transactions q No Minimum balance q Returned check images q Free check orders q Benefits such as added insurance, travel options, identity protection efree Checking Account No monthly service charge No minimum balance Secure and convenient estatements No foreign ATM fee assessed by 4 rebated foreign ATM withdrawals per month Free internet banking, online billpay and debit card Required: valid email address and internet banking Encore Checking With our second chance account, you can: Regain your financial strength. Improve your credit scores. Eliminate costly check cashing fees. Unlimited check writing. Free internet banking and bill pay. Free debit card. $10 per month maintenance charge or $8 with Direct Deposit. If you maintain this account in the agreed upon manner for 18 months you can move to a free account. Premier Members Checking Account Package Imaged checks returned with statement No minimum balance Unlimited check writing Personalized checks - two single orders of checks per year Interest paid if minimum balance of $100.00 is maintained Free TABS and ebankingcenter (internet banking) 50% Discount on Cashier s Checks Safe Deposit Box Rental Discount Free photocopies (limit 10 per month) Free Fax Machine Use (limit 3 per month) Hotel and Motel Discounts $10,000 AD&D Insurance Identity IQ and Identity Theft 911 Prescription Drug Discounts Hearing Instruments Discounts Prescription Eyewear Discounts Group Travel opportunities detailed in Quarterly Newsletter $20,000 Common Carrier Insurance AD&D Other discounts on Travel, Leisure and Shopping through Easy Saver (see fulfillment flyer for full details) Only $5.00 a month. Keep $10,000 in combined deposit relationships and all the above Premier Members benefits are yours free! Other accounts: Money Market Account Premium Money Market Account - tiered for higher interest rates Statement Savings Certificates of Deposit Individual Retirement Accounts See all our accounts on our website www.cbnkcc.com 4
Direct Deposit Change Form Complete this form and provide it to your employer s Human Resources or Payroll Department or any other direct deposit Companies I am closing my checking account with _. Your Name Current Bank I hereby authorize you to change my direct deposit from the checking account you have on file, at the bank listed above to my new Citizen Bank Account Number account as listed below: Checking Account number: Routing/Transit number: 0421-0233-5 Effective : q Split Deposit into multiple accounts 1. Account number: Type of account (checking / savings): Amount / percentage to be deposited: 2. Account number: Type of account (checking / savings): Amount / percentage to be deposited: Thank you for your attention to this matter. Signature Attach a new voided check here. 5
Automatic Debit Change Form Complete this form for each company or organization where you have automatic payment. Once completed, mail the form directly to each company or organization. I am closing my checking account with _. Your Name Current Bank I hereby authorize you to change my account which has an automatic payment in the amount of $ to be changed from the checking account you have on file with the if applicable account # with this company bank listed above to my new account as listed here: Checking Account number: Routing/Transit number: 0421-0233-5 - or - Debit Card number: Expiration : Effective of change: of next payment: Name (or name on account): Address City, State, Zip Thank you for your attention to this matter. Signature Joint Account Holder Signature Attach a new voided check here. 6
Account Closure Request Complete this form to request that your current bank account be closed. Once completed, mail the form directly to your current bank. Dear Sir or Madam, I hereby request that the following accounts with you be closed: Type (Checking / Savings): Type (Checking / Savings): Type (Checking / Savings): Type (Checking / Savings): Please prepare a cashier check for the balance of my account(s) made payable to me and mailed to: Name: Address: City, State, Zip: Phone: Thank you for your attention to this matter Signature Joint Account Holder Signature 7