Please sign me
up for Civis Bank Internet Banking. I understand there is no charge for
inquiries and transfers as well as no charge for the first 15
calendar month with
Civis Bank BillPay and a $.50 charge per BillPay transaction thereafter.
______________________________________ Date ___________
receipt of your signed application, instructions for accessing your account
online will be mailed to you within 7 days.
Print This Page
This form can
only be processed with your signature. Use
one form for each individual.
Enter the information in the application online, print, sign and return to
Internal Bank Use:
_____________________________________ SSN: _________________________
by:________ Date__________ Created
by:________ Date __________ Changed
by ________ Date __________
_______________________ Comment _________________________