Farmers State Bank Switch Kit

SwitchKIT
Farmers State Bank
Main Office: Dodge, NE
355 2nd Street
Dodge, NE 68633
Phone: 800.693.2251
Routing # (ABA): 104903498
Branch offices in Bridgeport and Alliance, NE
Complete Online at www.fsb-ne.com
SwitchKIT
Have you ever thought about switching your accounts to a new bank? If you're like a lot of
people, then the answer is yes. Maybe you're moving, you're tired of paying fees, or your
current bank just isn't providing the customer service you expect. Whatever the reason,
you just haven't switched. If it's because you think it's too much trouble, let us show you
how easy switching can be. With our Switch Kit, switching to Farmers State Bank has never
been easier!
1
Open a new Farmers State Bank checking or savings account:
• Stop by or call one of our branch offices
o Dodge - 402.693.2251
o Alliance - 308.761.1500
o Bridgeport - 308.262.1500
• Decide which account best fits your financial needs
• When you open your account you can enroll in other services,
such as Online Banking, Mobile Banking, and Bill Pay
2
Use this form to gather all of your auto pay and deposit information for easy reference
3
Notify all Direct Depositors and/or the payees on your Bills and Automatic Transfers
• Switch Kit Checklist
• To complete this process please use the forms provided:
o Automatic Payment Authorization
o Direct Deposit Authorization
4
Submit your account closure form to your previous financial institution
• To complete this process please use the following form:
o Account Closure Authorization
5
Bring your completed Switch Kit to your nearest branch and we'll help you take care of the rest
Print Form
Checklist
Use this form to gather all of your automatic payment and deposit information in one place for easy
reference.
Automatic Payments
Payment
Company
Account #
Amount
Payment Date
Amount
Deposit Date
Mortgage
Auto Loan
Insurance
Credit Cards
Gas/Oil
Utilities
Cable/TV
Telephone
Cell Phone
Internet
Investments
IRA/Retirement
Other
Automatic Deposits
Deposit
Company
Account #
Payroll
Retirement
Social Security
Investments
Other
Helpful Phone Numbers and Websites
Social Security Administration
Department of Veterans Affairs
1.800.772.1213
877.838.2778 or 800.827.1000
www.ssa.gov
www.va.gov
Print Page
Automatic Payment
Authorization
Use this form to change your automatic payments with any organization such as your utility provider or mortgage
lender. If you make any automatic payments using your credit or debit card you will need to contact those companies
and give them your new Farmers State Bank card number.
Note: Use one form for each automatic payment.
Automatic Payment Change Request
Company:
Address:
Account #:
City:
Payment Amount:
State:
Zip Code:
Phone:
Please accept this form as authorization to discontinue my automatic payment from my current account and make
all future payments using the following account:
New Financial Institution:
ABA/Routing Number:
Account Number:
If you have any questions regarding this change please contact me at my daytime phone number below. This
authorization should remain in effect until you are notified by me that it has been changed or cancelled.
Name:
Address:
Signature:
Phone:
City:
State:
Zip Code:
Date:
Print Page
Direct Deposit
Authorization
Use this form to change your automatic deposits with any organization such as your employer or retirement fund
agency.
Note: Use one form for each automatic deposit.
Direct Deposit Change Request
Company:
Address:
City:
State:
Zip Code:
Please accept this form as authorization to automatically deposit funds from the company above into the account
listed below. This authorization should remain in effect until you are notified by me that it has been changed or
cancelled.
Account #:
ABA/Routing Number:
Signature:
Name:
Date:
Phone:
Address:
City:
State:
Zip:
Print Page
Account Closure
Authorization
Use this form to authorize the closure of your account at your previous bank. You can select whether a check for the
balance of the account is sent to your mailing address or whether you will manage the withdrawal of funds prior to the
account closure. Before submitting this form be sure that all checks have cleared and all automatic payments and
withdrawals have been changed to your Farmers State Bank account.
Notification of Account Closure
Financial Institution:
Address:
City:
State:
Account #:
Owner:
Signature:
Date:
Zip Code:
Please send a check for the balance of my account to the address below.
I will transfer/withdraw the remaining funds out of my account.
If you have any questions about the closing of this account please contact me at the phone number below.
Name:
Address:
Phone:
City:
State:
Zip Code:
Print Page