(Internet Banking is not a feature of Regular Savings accounts.)

To sign up for Citizens Bank Online, complete this application, sign it and mail or FAX to:

Citizens Bank, N.A.
Attn.: Internet Banking
200 South Main
Fort Scott, KS 66701
FAX (620) 223-1336

If you have any questions or wish to receive an application by mail, contact Internet Banking at 800-530-5529 or (620) 223-1200, ext. 2369(Fort Scott).

Regulations require that we receive a signed application. Within five business days of receiving your signed application, you should receive your login information by e-mail at the address you indicate below.

The first time you log on, you will be prompted to change your temporary Access ID and password to the Access ID password of your choice.

Yes! I wish to apply for Citizens Online.

Yes! I wish to activate the Online Bill Pay feature.

Yes! I wish to recieve my account statements electonically. 

Last Name __________________ First Name: ________________

Middle Initial: ____

Address _______________________________________________

Apt. No. ________

City ___________________________ State _______ Zip _________

Home Phone __________________________

Work Phone ___________________________

Date of Birth __________________________ (for security purposes)

E-mail address _________________________________ (required)

Authorization:
By signing below, I indicate that I have read the Online Banking Agreement and agree to the terms and guidelines stated therein.

Signature: _________________________________ Date: ________________