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Make the Switch Checklist

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q

Fill out our Application Information and Current Deposits and Payments forms.

q

Bring your completed forms to any NBT Bank office. Stop in when it’s convenient for you or

call ahead to make an appointment.

q

When you visit us, your NBT Banker will:

• Open your new checking account and set up any additional services and/or accounts you need

(debit card, online banking, savings account, etc.).

• Assist you in the process of notifying depositors and/or payees that you want to redirect your

direct deposits and automatic payments to your new checking account. These notifications

may be made by mail or phone. If you prefer to handle your notifications on your own, the

form and letters are attached here and also posted on our website for your convenience.

q

Use the Current Deposits and Payments form to track that your direct deposits and automatic

payments have been successfully redirected to your new NBT Bank checking account.

q

When your deposits and payments have been redirected and any checks written on your old

checking account have cleared, use the Account Closing Request form to notify your old

financial institution that you would like to close your account(s).

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Application Information

Revised 9/28/07 mrk/rrf

Complete and bring this form to any NBT Bank office to make opening your new checking account quick and easy.

PRIMARY ACCOUNT HOLDER

Name: Date of Birth:

Address:

City: State: Zip:

Mailing Address (if different than above):

City: State: Zip:

Home Phone: E-Mail Address:

Social Security Number: Employer:

Work Phone:

Driver’s License Number*: Expiration Date:

JOINT ACCOUNT HOLDER

Name: Date of Birth:

Address:

City: State: Zip:

Mailing Address (if different than above):

City: State: Zip:

Home Phone: E-Mail Address:

Social Security Number: Employer:

Work Phone:

Driver’s License Number: Expiration Date:

For details on our checking account options, please talk to an NBT Banker at one of our conveniently located branches or contact our Call Center at 1-800-NBT-BANK (1-800-628-2265). Account

information is also available online at: www.nbtbank.com/ps_personal_banking.html

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Current Deposits and Payments Form

Member FDIC Revised 9/28/07 mrk/rrf

Use this form to summarize the direct deposits and automatic payments you want to transition to your new NBT Bank checking account. As your deposits and payments are redirected, you can use the spaces on the right side of the form to track that each transition was completed and note the date that the deposit or payment was first applied to your new account.

DIRECT DEPOSIT

Depositor Name: Address:

Phone:

Completed

First deposit made to new account on:

Depositor Name: Address:

Phone:

Completed

First deposit made to new account on:

Depositor Name: Address:

Phone:

Completed

First deposit made to new account on:

AUTOMATIC PAYMENTS

Payee Name: Address:

Phone: Account #:

Payment made via: Debit to checking account Debit Card

Completed

First deposit made to new account on:

Payee Name: Address:

Phone: Account #:

Payment made via: Debit to checking account Debit Card

Completed

First deposit made to new account on:

Payee Name: Address:

Phone: Account #:

Payment made via: Debit to checking account Debit Card

Completed

First deposit made to new account on:

Payee Name: Address:

Phone: Account #:

Payment made via: Debit to checking account Debit Card

Completed

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Authorization to Change My Direct Deposit

To:

I have opened a new account at NBT Bank. Please direct my: Existing direct deposit

New direct deposit

to my new NBT Bank account. Information about my account appears below.

NBT Bank Routing #: 021303618

My New NBT Bank Account #:

_ _ _ _ _ _ _ _ _ _

Name: Address: City/State/Zip: Social Security #: Telephone #: Signature: Date:

(5)

Authorization to Change My Automatic Payment

To:

Re: Account Number with Company

I have opened a new account at NBT Bank. Please redirect my automatic payment to my new NBT Bank account. Information about my account appears below.

NBT Bank Routing #: 021303618

My New NBT Bank Account #:

_ _ _ _ _ _ _ _ _ _

Name: Address: City/State/Zip: Telephone #: Signature: Date:

(6)

Authorization to Change My Recurring Debit Card Payment

To:

Re: Account Number with Company

I have opened a new account at NBT Bank. Please withdraw my payment from this account using my new debit card.

NBT Bank Debit Card #:

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Expiration Date:

_ _

/

_ _

Month/Year From: Name: Address: City/State/Zip: Telephone #: Signature: Date:

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Account Closing Request

To:

From:

Please close the following account(s) with your institution:

Account #: Type of Account:

Account #: Type of Account:

Account #: Type of Account:

Social Security #:

If you require any additional information, you can reach me at:

Please mail the funds from the account(s) in the form of an Official Bank Check made payable to:

Name:

Address:

City: State: Zip:

Thank you for your prompt attention to this matter.

Sincerely:

Signature of Primary Account Holder Date

References

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