Texas First Online Banking Enrollment Form

To sign up for Internet Banking, complete and print the application. Sign the form and send it to Texas First State Bank via US mail, fax or hand deliver to any Texas First State Bank location. Once the form is returned to us, you will receive an email within 48 hours containing your login ID and first time password.
 CUSTOMER INFORMATION
New User: Existing User Modification:
First Name:
Last Name:
Address:
TIN/SSN:
City:
State:  Zip: Phone:
E-Mail:
  CUSTOMER INFORMATION
Internet Banking
Bill Payment
Access account balances, transfer money, and conduct common banking tasks online Pay bills on-line. Pay any individual or company. $3.95 per mo with 10 electronic items and $0.35 for each item after the first 10 and all paper items - first 2 months free
  CUSTOMER INFORMATION
Account Number and 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 these accounts.
I certify that everything I have stated in this application and on any attachments is correct.  You may keep this application whether or not it is approved.  By typing and submitting this form, I authorize you to check my credit and employment history, to have a consumer credit report prepared on me for the purpose of evaluating this application for credit, and to answer questions others may ask you about my credit record with you.  I understand that I must update this credit information at your request and if my financial condition changes.

SIGNATURES: By signing below, I authorize Texas First State Bank to issue a temporary password on my behalf which I will be forced to change to a private password the first time I log in to the system.

Applicant Signature: _________________________ Date: _____/_____/_____
 
Joint Applicant Signature: _________________________ Date: _____/_____/_____