SIGN UP FOR ESTATEMENTS

* Required Fields

Customer or Business Name*:

SSN or TIN*:

Account #1*:

Account #2:

Account #3:

Email*:

You consent to the electronic delivery of any legal or regulatory disclosures and communications related to your Account. You also agree that Forcht Bank does not need to provide you with an additional paper (non-electronic) copy of legal or regulatory disclosures, unless specifically requested.*
I Agree    I Do Not Agree


FOR INTERNAL USE ONLY

Employee Name:

Branch Number:

Consent Type:


Welcome to the Forcht Bank Electronic Bank Statement Service. Our goal is to provide you with an easy, convenient and efficient way to receive your periodic Bank Statements.

This enrollment form asks for your consent so that we can provide monthly account statements and disclosures to you in an electronic format rather than a paper format. In order to receive electronic statements, you are required to be enrolled in the bank's Online Banking system.

If you elect to receive your Bank Statements through electronic delivery, the Bank will no longer send you your statements through the mail. By clicking accept to this enrollment form, you are giving the Bank your consent. The Bank is then authorized to electronically forward to you your periodic Bank Statements for your specified account(s) and any other disclosures related to that account(s).

By agreeing to have your Bank Statements provided electronically, you also agree to notify Forcht Bank, immediately of any change in your email address or any errors or complications relating to your electronic receipt or access of your Bank Statements. You may also update your email address by accessing your online banking account at www.forchtbank.com and logging in with your assigned ID and password.

To withdraw your consent to receiving your statement electronically you must notify the bank in writing. It may take up to 45 days for the Bank to implement your request, and after such time you will no longer receive your statements electronically. We will charge no fees for discontinuing the service.

The same terms apply with respect to electronically provided Bank Statements as for those delivered in paper form, and the deposit agreements and disclosures that you have previously entered into with or received from the Bank remain in effect.

To access eStatements you will need to be enrolled in Online Banking. A system requirement for Online Banking is a 128-bit encrypted browser. If you are using Internet Explorer, it must be at least 6.0 or 6.1 for Netscape. To open the eStatement you will need Adobe Reader 7.0 or higher, this product is available for free at http://www.adobe.com. If your personal computer does not meet these requirements, please do not continue with enrollment.

We reserve the right to cancel your participation in this program at any time. Please note, the Terms and Conditions for Internet Banking also apply to your use of this service.

After you have given consent to enroll for E-statements, you may upon request, obtain a paper copy of an electronic record. You may request this per telephone 1-844-4-FORCHT between 8 a.m. and 6 p.m. Monday through Friday and 8 a.m. to noon on Saturday. or by mailing or visiting one of our banking center locations. Please refer to the "contact us" section of Forcht Bank's website for all locations' addresses and hours of operation. Please refer to the fee schedule for applicable fees.

I have read and agree to the terms and conditions stated above. I understand that by clicking accept to this agreement I will stop receiving my paper statements.