Int Bank Enroll

Questions?
715-284-5341
ext. 1301, 1304, 1305

INTERNET BANKING ENROLLMENT

By enrolling in Internet Banking below, you agree to the terms of the Internet Banking section of the Internet Banking and Internet Bill Payment Disclosures. By enrolling, you will have access to account information on which you have Primary or Co-ownership, and will have the ability to transfer between properly related eligible accounts.

Internet Banking Services Allow You To:
View account information View current balance View account history Download account information Initiate stop payments View check and deposit images View statement information Report an ATM or Debit Card lost or stolen.	Transfer funds from a checking or savings account to a checking or savings account Transfer funds from a line of credit to a checking or savings account Make payments from a checking or savings account to a loan account with us Make transfers to or from an Overdraft Protection Line with the corresponding checking account *Set up event alerts

Optional Services:

EStatements are available as an Internet Banking user. With eStatements, you may receive your bank statements electronically. It's convenient, safe and easy. You may enroll by logging in to your Internet Banking account and clicking on the eStatement tab.

Internet Bill Payment is an optional service that allows you to set up one time or recurring payments from your checking account. Internet Bill Payment offers the freedom from writing checks and mailing payments. Get details online or call a Personal Banker at (715) 284-5341. Subject to Bank approval and fees.

You will need a Jackson County Bank deposit or loan account, Internet access and a browser with the proper encryption capabilities to bank online. For security purposes, you will then be mailed your Internet Banking identification number and password instructions.

You are submitting this Internet Banking Enrollment form to:
JACKSON COUNTY BANK
Black River Falls, Wisconsin
Click if you prefer to mail or FAX this form.

Use the "Tab" key to advance to the next field. "Enter" will submit the form.

Personal Information

USER 1
First M Last Name

Last four digits of Social Security #
mm/dd/yyyy Date of Birth
E-mail
Address
City
State Zip
Telephone #

USER 2
First M Last Name

Last four digits of Social Security #
mm/dd/yyyy Date of Birth
E-mail Address
City
State Zip
Telephone #

Identification Information

Please provide the identifying information below. Provide at least one test question and answer that may be used to identify you if you need your PIN reset.

Choose one: or type your own question below:

Answer:

Please print the Internet Banking Agreement and Disclosure Statement before you submit your application to Internet Banking.

By submitting this form I, acknowledge receiving the Internet Banking and Internet Bill Payment Disclosures, I agree to the terms of the disclosures and this enrollment form, and I acknowledge receipt of the Federal Electronic Transfer Act Disclosure.*

I understand that account security is controlled by the Internet Banking ID assigned by the Bank, and the Personal Password chosen and entered by me. I understand it is my responsibility to protect the password and keep it confidential, and will hold the bank harmless from unauthorized use. Any information downloaded by me becomes my property and responsibility.

*You received Agreement and Disclosure for Electronic Fund Transfers and Automated Teller Cards when you opened your account. Please call 715-284-5341 if you would like another copy.