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Please print, sign, and date this form and return it to any Peoples Bank Co. office or mail it to us at:
The Peoples Bank Co.
Attn: Internet Banking Department
P.O. Box 110
Coldwater, OH 45828
The Peoples Bank Co. must have this completed and signed form on file before we send you your initial password for internet banking. Your initial password will be e-mailed to you. You will need to use your initial password to create your personal Access ID and new password.
(You are the only person that should have access to your Access ID and password so please safeguard this information.)
I certify that I have read and agree to all terms, conditions, and disclosures on the website, and I have accurately and fully completed all items on this application.
Under penalties of perjury, I certify that (1) the social security number indicated above is my number and (2) I am a U.S. citizen or resident
alien.
Signature: _______________________________________
Date: ___________________
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