Business Internet Banking Application

REQUESTED SERVICES
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Includes account inquiry, account alerts, account transfers, Bill Payment, report requests, snap history, statement reprint, stop payments and Loan payments.

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* ADDITIONAL MONTHLY AND ITEM FEES APPLY

Complete Pg. 2 for ACH Origination and Wire transfer

Login Information


Login ID


Password
CUSTOMER INFORMATION

Business Name:
Tax ID:
Address:
City:
State :
Zip :
E-mail:
Ph:
Fax:
ADMINISTRATOR INFORMATION (complete only if Cash Management Access was selected above)

Name (First Middle Last):
Title:
Ph:
SSN:
E-mail:
LIST OF ACCOUNTS TO ACCESS
BY SUBMITTING THIS APPLICATION YOU AGREE TO THE FOLLOWING
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Cash Management Access

Complete only if ACH Origination or Wire transfer was checked under Cash Management on Page 1

ACH ORIGINATION APPLICATION


First Volunteer Bank customer since:
Years in Business:
ACH Contact Information (secondary ACH contact to the Administrator)
Name:
E-mail:
Ph:
Account Information
Settlement Account(s):
Billing Method:
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Type of Business

Description of Business products and/or Services:

Does the company have offices in foreign countries?
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Does the company buy or sell to organizations outside of the U.S.?
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Does the company send payroll, pension or benefit payments to individuals outside of the U.S.?
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Transaction Frequency & Delivery


ACH Applications:
checked Direct Deposit
checked Pre-Authorized Debits
checkedCash Concentration & Disbursement
checkedPre-Notes
Frequency::
checkedDaily
checkedWeekly
checked Monthly
checkedSemi-Monthly
checkedACH files submitted be balanced files.



*Credit Files must be delivered to Bank no later than two (2) days before settlement date.
*Debit Files must be delivered to Bank no later than one (1) day before settlement date.
Estimated File Information
Total Transactions Items:
Credits:
Debits:
Total Maximum Dollar Amount/File $ :
*First Volunteer Bank reserves the right to terminate or suspend an ACH Originator for breach of the Rules within 10 banking days. First Volunteer Bank also reserves the right to audit an ACH Originator's compliance with the ACH Agreement and the Rules.
ACH ORIGINATION APPLICATION
Shown below is the account with First Volunteer Bank from which funds may be transferred in accordance with the Wire transfer Agreement between the Customer and the Bank:
Account to Debit Wire Funds from:
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