UNION STATE BANK - INTERNET BANKING SETUP FORM

Offices in Kewaunee, Green Bay and Two Rivers, Wisconsin
Customer Name(s):
Customer Address:
City, State, ZIP Code:
Customer E-Mail Address:

Log-in ID:

(letters, numbers or a combination of both)

 Password:

 

(FOR BANK USE ONLY)
Social Security #: Date of Birth:
       

Account Access Choices:

Access

 Account Number Account Type
FULL: 
You will have full access available on this account.
VIEW ONLY:
You will be able to view balances and transactions.
DEPOSIT ONLY:

You will be able to transfer funds into this account from other

accounts with Full Access.  You will not be able to view

balance or transaction information.
VIEW & DEPOSIT:

You may view account information and transfer funds into this

account.
*If you want FULL Access to all your accounts with Union State Bank, please write "ALL" under Account Number.  All personal accounts under your social security number will have Full access.
   
* Individuals with both personal accounts and Corporation, Partnership or LLC accounts must complete a separate agreement for access to business accounts.  Personal and business accounts will not be available under one agreement.
I have received the Internet Banking Agreement & Disclosures on:
I want the ability to order Savings Bonds on the Internet Banking System: Yes                    No
   
Signature:  
   
Signature:  
   

Return completed form to:

UNION STATE BANK

PO BOX 337

KEWAUNEE, WI 54216-0337 

Please DO NOT email this form to us.  Email is not a secure way to send confidential information.  Please print and mail this form.
 

WE WILL EMAIL YOU A TEMPORARY PASSWORD ONCE WE RECEIVE THIS COMPLETED FORM.

IF YOU DO NOT HAVE EMAIL WE WILL MAIL THE PASSWORD TO YOU.