FIRST NATIONAL BANK
CONSUMER INTERNET BANKING ENROLLMENT FORM
Complete, sign and return this form to the bank. If you do not have the ability to print these documents, please contact us at 606-598-6111
Customer Information
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Name Social Security
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Street Address City State Zip
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E-Mail Address Primary Checking Account
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Telephone Number Additional Authorized User(s)
Customer Agreement
By signing below:
• I am enrolling in “Consumer Internet Banking” as indicated on this enrollment form.
• I acknowledge receipt of First National Bank's Electronic Funds Transfer Agreement and Privacy Statement.
• I have read and agree to comply with the “Consumer Internet Banking Agreement & Disclosure”. and any other agreements governing the accounts and features of this service.
• I authorize First National Bank to honor electronic instructions to transfer money to other First National Bank accounts and process bill payment requests.
• I acknowledge transfers and bill payments will be processed when the User-id(s) and Password(s) of the signer(s) designated by me now or in the future have been entered into the system.
Signature
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Date
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