CBETN Secure E-Mail Statements

Agreement to Receive Checking Account Statements via E-Mail.







Checking Acct #:

Daytime Phone:


Password for Statements:

12 characters minimum with Upper Case, Lower Case, Numbers & Special Characters!





Please sign me up for CBETNís Secure E-Mail Statements to be delivered to my email address stated above.I understand that my statements will be sent to me encrypted and I must use my password designated above to open the statement.I also understand that I may, at any time, revoke this agreement and receive my statements via US Postal Service by providing notice in writing to The Citizens Bank of East Tennessee.


I further understand that in order to open the Secure E-Mail Statement I must download and install on my computer a free version of Adobe Acrobat Reader version 7 or greater.This software can be found at:http://www.adobe.com

Signature ________________________________________    Date ______________

Upon receipt of your signed agreement we will begin emailing your statements on your next statement cycle.Please note that at any time you may still come into any branch and get a printed copy of your statement and check images!

This form can only be processed with your signature. Use one form for each individual account.
Type the information in this application online, print it, sign it and send it to:

The Citizens Bank of East Tennessee
P.O. Box 550, Rogersville, TN37857
Phone 423-272-2200†††† Fax 423-272-2322

Print This Page

For Internal Bank Use:



Comment: ________________________________________________________________________________



Authorized/Received by:____________ / __________    Entered into ImageChex32 by:_____________ / __________  

                                         Date             Initials                                                          Date              Initials