Colonial Co-operative Bank

Member FDIC
Member SIF
Colonial
Co-operative Bank
SWITCH KIT
Welcome to Colonial! We make switching to
Colonial stress-free... by putting all the
important forms you’ll need in one place!
Just fill in the requested information
(where applicable) and we’ll take it from
there!
Call us with questions. We’re here when you
need us.
Main Office: 6 City Hall Ave, Gardner, MA 01440
Ph. 978-632-0171 | Fax 978-632-1423
Branch Office: 1 School Sq Winchendon, MA 01475
Ph. 978-297-2447 | Fax. 978-297-3024
www.colonial4banking.com
Direct Deposit Authorization Form
Customer:
To: _____________________________________
Date:______________________
_________________________________________
_________________________________________
Type of Direct Deposit:
Employee Payroll
Social Security
Other, Please Specify
Investment Income
Retirement/Pension
This letter serves as authorization for you to change the customer account information for automatic
deposits for account number _________________________ in the names of:
______________________________________________________.
Effective as of the date of this correspondence, the customer’s new account information is:
Colonial Co-operative Bank
Account Number: _________________
Bank Routing Number: 211370668
Thank you,
I hereby authorize the changes noted about to my account.
_____________________________
Account Holder’s Signature
______________________
Date
____________
Telephone
_____________________________
Account Holder’s Signature
______________________
Date
____________
Telephone
MAIN OFFICE:
BRANCH OFFICES:
6 CITY HALL AVENUE
1 SCHOOL SQUARE
GARDNER MA 01440
WINCHENDON MA 01475
www.colonial4banking.com
TEL. 978-632-0171
TEL. 978-297-2447
FAX 978-632-1423
FAX 978-297-3024
Member FDIC | Member SIF
Automatic Payment Authorization Form
Customer:
To: _____________________________________
Date:______________________
_________________________________________
_________________________________________
This letter serves as authorization for you to change the customer account information for automatic
payments for account number _________________________ in the names of:
______________________________________________________.
Effective as of the date of this correspondence, the customer’s new account information is:
Colonial Co-operative Bank
Account Number: _________________
Bank Routing Number: 211370668
Thank you,
I hereby authorize the changes noted about to my account.
_____________________________
Account Holder’s Signature
______________________
Date
____________
Telephone
_____________________________
Account Holder’s Signature
______________________
Date
____________
Telephone
MAIN OFFICE:
BRANCH OFFICES:
6 CITY HALL AVENUE
1 SCHOOL SQUARE
GARDNER MA 01440
WINCHENDON MA 01475
www.colonial4banking.com
TEL. 978-632-0171
TEL. 978-297-2447
FAX 978-632-1423
FAX 978-297-3024
Member FDIC | Member SIF
Debit Card Authorization Form
Customer:
To: _____________________________________
Date:______________________
_________________________________________
_________________________________________
This letter serves as authorization for you to change the customer account information for automatic
payments for account number _________________________ in the names of:
______________________________________________________.
Effective as of the date of this correspondence, the customer’s new account information is:
Colonial Co-operative Bank
Account Number: _________________
Bank Routing Number: 211370668
Thank you,
I hereby authorize the changes noted about to my account.
_____________________________
Account Holder’s Signature
______________________
Date
____________
Telephone
_____________________________
Account Holder’s Signature
______________________
Date
____________
Telephone
MAIN OFFICE:
BRANCH OFFICES:
6 CITY HALL AVENUE
1 SCHOOL SQUARE
GARDNER MA 01440
WINCHENDON MA 01475
www.colonial4banking.com
TEL. 978-632-0171
TEL. 978-297-2447
FAX 978-632-1423
FAX 978-297-3024
Member FDIC | Member SIF
Loan Payment Authorization Form
Customer:
To: _____________________________________
Date:______________________
_________________________________________
_________________________________________
This letter serves as authorization for you to change the customer account information for automatic
payments for account number _________________________ in the names of:
______________________________________________________.
Effective as of the date of this correspondence, the customer’s new account information is:
Colonial Co-operative Bank
Account Number: _________________
Bank Routing Number: 211370668
Thank you,
I hereby authorize the changes noted about to my account.
_____________________________
Account Holder’s Signature
______________________
Date
____________
Telephone
_____________________________
Account Holder’s Signature
______________________
Date
____________
Telephone
MAIN OFFICE:
BRANCH OFFICES:
6 CITY HALL AVENUE
1 SCHOOL SQUARE
GARDNER MA 01440
WINCHENDON MA 01475
www.colonial4banking.com
TEL. 978-632-0171
TEL. 978-297-2447
FAX 978-632-1423
FAX 978-297-3024
Member FDIC | Member SIF
Checklist for Direct Deposits to Your Account
Direct Deposit
Payer
Amount
Date Paid
Account #
Your Pay
Social Security
Pension/Retirement
Investment Income
Other
Other
Checklist for Automatic Payments and Bill Pay From Your Account
Payments
Mortgage or Rent
Car Loan
Credit Card
Credit Card
Electric
Gas/Oil/Coal
Company
Amount
Due Date
Account #
Telephone
Cell Phone
Water
Sewer
Garbage
TV Cable
Internet Service
Insurance
Gym/Health Club
Daycare
Other
Other
Other
MAIN OFFICE:
BRANCH OFFICES:
6 CITY HALL AVENUE
1 SCHOOL SQUARE
GARDNER MA 01440
TEL. 978-632-0171
WINCHENDON MA 01475
TEL. 978-297-2447
www.colonial4banking.com
FAX 978-632-1423
FAX 978-297-3024
Member FDIC | Member SIF