Online Banking Enrollment

Jumpstart Application

HOW TO APPLY

Current Customers:
Complete and submit the application below and after verification we'll set up and issue your personal ID and PIN. If you are not an existing customer of Community Bank, please visit one of our branch offices to open your account.

Non-Customers
You must be a Community Bank customer to enroll in Online Banking and Bill Pay - please visit a local branch to open an account and we'll help you get started.

*Indicates a Required Field

Applicant Information
Are you a current Community Bank Customer?  
Personal or Business


Online Banking and/or Bill Pay Information

Date:
Business Name:
First Name:*
Middle Initial:
Last Name:*
Mailing Address:*
 
City:*
State & ZIP:* ,
Permanent Address:*
(no PO Boxes)
 
City:*
State & ZIP:* ,
Home Phone:*
(000-000-0000)
Cell Phone:
(000-000-0000)
Date of Birth:*
(mm/dd/yyyy)
Social Security Number:*
(000-00-0000)
Tax ID:*
Mother's Maiden Name:
Email Address:*
(youraddress@yourhost.com)
Applicant Online Banking Information
- or -
Account Number Descriptive Name
Applicant Bill Pay Information
Checking account to pay bills from:
CUSTOMER CONSENT & ACKNOWLEDGEMENT:

By typing, printing, signing, and/or submitting this form online, I/we certify that everything I/we have stated in this form is correct and agree to the terms indicated below. I/we understand that I/we will be contacted by a representative to either complete the process or obtain additional information. I/we understand that additional information may be required for processing. I/we further understand that if the submitted information is approved, I/we agree to receive all disclosures, provide identification, and sign agreements/documents in person at the time I/we visit Community Bank. If the submitted information is not approved, I/we agree to receive all disclosures by mail. I/we further understand that Community Bank may also keep this information whether or not an account opening results. I/we authorize you to check my/our credit (for loan requests only), verify current and previous bank account information, employment history, and any other information submitted with this form. For loans: I/we also agree to update credit information at our request.

NOTE: By submitting this form, you agree that you have read, understand and agree to the terms and information stated above. This form may be submitted by using ANY of the methods below.

SUBMIT online to immediately transmit electronically

OR...

PRINT & SIGN to fax/mail/drop by your form to one of our locations.

Signatures necessary only for faxed/mailed/drop by forms.

PLEASE PRINT AND RETAIN A COPY OF THIS INFORMATION FOR YOUR RECORDS

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