Internet Banking Application

Account Holder Information

*Customer Name  
Business Name  
 Business Contact  
*Address  
*City, State, Zip  
*Home Phone  
 Work Phone  
 Cell Phone  
 Fax  
*SSN or Taxpayer ID  
*Mother's Maiden Name  
*E-mail Address  

Funds Access

The following section allows you to identify the accounts to which you desire access through the Internet. Please supply the type of account and the account number. Federal Regulations allow only six (6) transfers or withdrawals per calendar month from savings accounts.

Accounts to add to Internet Banking

*Acct# *Acct Type *Acct Title
Acct# Acct Type Acct Title
Acct# Acct Type Acct Title
Acct# Acct Type Acct Title
Acct# Acct Type Acct Title

*Required

Account Types

OEL = Ready Cash Reserve or Equity Line or Credit (Payments "into" allowed only)
DDA = Checking (Transfers "In" or "Out" allowed)
SAV = Savings (Transfers "In" or "Out" allowed)
CDA = Certificates of Deposit ("In" transfers allowed only on 12 & 18 month variable)
ILA = All other loan Types (Payments allowed only)

Internet Banking Agreement / Disclosure

This Internet Banking Agreement and Disclosure ("the Agreement") explains the terms and conditions governing basic Internet banking services and bill pay services offered by Cornerstone National Bank (collectively "Internet banking services"). By using any of the Internet banking services, you agree to abide by the terms and conditions of this Agreement.

The terms "we", "us", "our", and "Financial Institution"í refer to Cornerstone National Bank. "You" refers to each person who enrolls for Internet banking services and has a password. The term "business days" means Monday through Friday, excluding Saturday, Sunday and Financial Institution holidays.

Your Internet banking services and each of your accounts are also governed by the applicable Disclosures, Rates, and Fee Schedules provided by Financial Institution in your new account packet as each may be modified from time to time. Collectively, "Cornerstone National Bank" documents.

You are responsible for paying any fees associated with Internet banking and bill payment as outlined by "Cornerstone National Bank" as well as any additional fees that may be assessed by your Internet Service Provider and for any telephone charges or fees incurred by accessing Internet banking services.

Your initial use of Internet banking services constitutes your acceptance and agreement to be bound by all of the terms and conditions of this Agreement and by "Cornerstone National Bank", and acknowledges your receipt and understanding of this agreement.

Financial Institution is entitled to act on instructions received through Internet banking under your password and without inquiring into the identity of the person using that password. However, do not, under any circumstances, disclose your password by telephone or to any one claiming to represent Financial Institution; Financial Institutionís employees do not need and should not ask for your password. You are liable for all transactions made or authorized using your password. Financial Institution has no responsibility for establishing the identity of any person using your password. If, despite Financial Institutionís advice, you give your password to anyone, you do so at your own risk since anyone to whom you give your Internet banking password or other means of access will have full access to your accounts even if you attempt to limit that personís authority. You must notify Financial Institution that your password has been lost, stolen or otherwise compromised and should not be honored and must be disabled.

If two people hold a joint checking account, then there are two ways to enroll for Internet banking services. Both account holders may enroll separately and each will have his/her own password, and his/her own separate Internet banking Agreement. Each such joint account holder is subject to separate Internet banking Service fees as applicable. Alternatively, one holder of a joint account can enroll for Internet banking Services with one password issued and be subject to fees for one person. You are liable for all transactions that you, or if you are using a joint Bill Payment Account, any of you, make or authorize even if the person you authorize exceeds your authority. You hereby release Financial Institution from any liability and agree not to make any claim or bring any action against us for honoring or allowing any actions or transactions where you have authorized the person performing the action or transaction to use your account(s) and/or you have given your password to such person, or, in the case of a jointly held account such person is one of the owners of the account. You agree to indemnify Financial Institution and hold it harmless from and against any and all liability (including but not limited to reasonable attorney fees) arising from any such claims or actions.

Financial Institution has the right to modify or terminate this agreement at any time. We will comply with any notice requirements under applicable law for such changes or termination. If we terminate this Agreement, no further Internet banking transfers or bill payments will be made, including but not limited to any payments or transfers scheduled in advance or any pre-authorized recurring payments or transfers. If we modify this Agreement your continued use of Internet banking Services will constitute your acceptance of such changes in each instance.
Persons listed on a profile will only be able to access accounts for which they are designated as an owner. If you wish to access information on an individual account, you must have an individual profile. Persons with individual accounts may also access joint accounts for which they are an owner through an individual profile. However, persons listed on a joint profile will only be able to access accounts on which all parties to the profile are also listed as account owners.

By signing this agreement, I acknowledge that I have read and accept the Electronic Disclosures as provided on this web site.

I would like a copy of this agreement and the disclosures to be mailed to me.

* All authorized owners on all accounts must sign this agreement.

Account Holder Signature or Authorized Signer

Date
Account Holder Signature or Authorized Signer

Date
Account Holder Signature or Authorized Signer
 
Date

Please note that applications submitted will not be processed until we have verified your information and identity by having you visit one of our Cornerstone National Bank offices. A Customer Service Representative will contact you within 2 business days of your request.