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COMMUNITY BANK SWITCH KIT

Making the switch to Community Bank has never been easier. Fill out the information below and bring this form in to one of our locations. A friendly personal banker will assist you in opening your new account.

Step 1 New Account Information

Individual Account

Name Street Address City, State, Zip Mailing Address (if different) Home Phone Drivers License Number Date of Birth Employer/Occupation Signature Name Street Address City, State, Zip

Joint Account

Mailing Address (if different) Home Phone Drivers License Number Date of Birth Employer/Occupation Signature

X

X

*Your social security number is also required when opening an account but is not included in this form for security reasons. Step 2 Direct Deposit Information

Name Previous Bank Previous Bank Account # Account Type Checking Savings Checking Savings Checking Savings Checking Savings

Step 3

Automatic Payment Authorization

Account Number Amount Date to be Paid

Name of Company

Information

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