Net Express Enrollment Form

 

 

Customer Information:

 

Primary Account Holder:

Secondary Account Holder:
(if joint account)

Address:

City:

State:

  Zip:   Phone: 

E-Mail:

Last 4 digits of
Social Security Number:

 

Requested Services:

 

Internet Banking

 

Small Business with Bill Pay

 

Access account balances, transfer money and conduct common banking tasks online all free of charge.  Pay unlimited bill online for free if you have Value, Bonus or SuperNOW Checking.  Bill Pay is just $0.50 per bill for Free and Personal Checking

 

 

Add online Bill Pay for just $5.95 per month for the first 10 payments and $0.50 each thereafter.

 

 

 

 

 

Small Business Banking

 

 

 

 

Small businesses can access account balances, transfer money and conduct common banking tasks online free of charge.

 

 

 

 

Account Information:

 

Note: If you are enrolling jointly, both account holders must be authorized on any accounts you request access to. Otherwise, each account holder should enroll individually and will receive a separate password.

 

Account Number

Access Type*

Account Description, as you identify this account:

 

1)

2)

3)

4)

5)

6)

7)

8)

 

 

 

* Definitions for Access Types:

  • Full Access - You will have the full access available on this account.
  • View & Deposit - You may view account information and transfer funds into this account.
  • View Only - You will be able to view balances and transactions.
  • 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.

Please Note: You must be an authorized signer on each of the accounts you request access to. All owners on an account must sign below.

X______________________________________________ ________________

Signature of Primary Account Holder Date

X______________________________________________ ________________

Signature of Secondary Account Holder (if different) Date

Please print this form using the "PRINT" button above, sign it, and mail it to us at:

Union Bank
ATTN: Internet Banking Department
PO Box 488
Lake Odessa, MI 48849

We will notify you by U.S. mail when we have activated this service(s). We will assign a Login ID for you and a temporary password. The first time you log on to our Online Banking Service you will be prompted to select a new password. We encourage you to select a password that is not associated with any commonly known personal identification, such as names of children, address, and date of birth. We recommend that you select a password that contains both letters and numbers and uses upper and lower case letters. These additional precautions will help safeguard the integrity of the Online Banking Service.