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Online Banking Enrollment Application

Please complete the following.
All information will remain confidential.

* = Information Required.

Customer Service: 417-739-9300
Please include your phone number if you need immediate help.

Name: *
Phone Number: *
Address: *
City & State: *
E-Mail: *

How Can We Help?:

This form is for general
communications and is not
secure. Please DO NOT
include your Social Security
number or account numbers.

Bill Pay Service
I would like the Optional Bill Pay Service for $4.00 per month, which includes up to 12 payments and any additional payments at $0.40 each. “I would like to receive my monthly statements via email instead of by mail.  The monthly fee of $4.00 for 12 payments will be waived.  Sign your Initials to Agree
I do not want the Bill Pay Service Sign your Initials to Decline

 

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