Application Form

To sign-up you must have a Centier Checking account, Visa^® Debit Card and Savings / Money Market account. Business accounts are not eligible. Required Information*

Date 00138

First Name

Last Name 00149

Street Address 00140

Apt. # 00141

City/Town 00142

State

Zip 00144

E-mail Address 00145

Re-enter E-mail Address 00146

Checking Account Number

Where do I find my account number?

Savings Account Number

Where do I find my account number?

Note: It will take 3 to 5 Business Days for changes to take effect.

Terms and Conditions Christmas Club, Health Savings Accounts, any passbook savings account, and Business accounts are not eligible. Savings accounts tied to Round Up require a $25 minimum opening balance. Monthly savings minimum balance fees will be waived provided there is at least one Round Up transaction per month. Savings fee structure reverts to standard account requirements if Round Up is discontinued. Account rates are subject to change. Fees may reduce earnings. All other account disclosures remain unchanged. Money Market minimum balance requirements, fee structures and all associated disclosures remain unchanged when enrolled in Round Up Savings. All Visa^® Debit Cards can be linked to one savings account. All Visa^® Debit Cards connected to the checking account(s) will round up to savings. Both signature and PIN transactions made with Centier Visa^® Debit Cards qualify for Round Up Savings. You must be an account owner on each checking and savings or Money Market account you enroll. Round Up amounts will accumulate for one transfer to your savings or Money Market per day. Centier reserves the right to modify the program at any time. MEMBER FDIC

I agree to the above terms and conditions.

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