UNION STATE BANK - INTERNET BANKING SETUP FORM

Offices in Kewaunee, Green Bay and Two Rivers, Wisconsin

 

ONLY ONE SIGNER IS ALLOWED PER AGREEMENT AND LOG-IN ID

 
PERSONAL ACCOUNT BUSINESS ACCOUNT
Name:

Name:

Mother's Maiden Name:

Authorized Signer:

Date of Birth:

Business TIN:

Social Security  #:

 

Street, City, State, Zip:

EMAIL Address:

Log-in ID:  (letters, numbers or a combination of both)

Password:

 

(FOR BANK USE ONLY)

*Account Access Choices:

Access

Account Number Account Type
FULL:  You will have view, deposit and withdrawal access on this account.
VIEW ONLY:  You will be able to view balances, transactions and account history.
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:
 
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.