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Stop using your old account(s) and fill out the AUTOMATIC TRANSACTION INVENTORY CHECKLIST to help you prepare for step 2.

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It’s easy to switch your account(s) to Timberline Bank. The following

SWITCHKIT

checklist

and forms will help us make the transition as seamless as possible for you.

#1 PREPARE

Complete the NEW ACCOUNT CUSTOMER INFORMATION form and visit us at one of our bank locations and a Banking Specialist will help determine what Solutions are best for you.

Stop using your old account(s) and fill out the AUTOMATIC TRANSACTION INVENTORY CHECKLIST to help you prepare for step 2.

#2 MOVE

Switch your direct deposits. Once your Timberline checking account is open, complete the

AUTHORIZATION TO CHANGE AUTOMATIC DEPOSIT form which will be used to notify any company that makes a direct deposit on your behalf. Be sure to attach a cancelled check from your new Timberline Bank account with your form. Companies can include your employer, Social Security, retirement plans, etc. Social Security deposits can be changed via phone at 1-800-772-1213 or visit their website at www.ssa.gov.

Switch your automatic payments. Use the AUTHORIZATION TO CHANGE AUTOMATIC WITHDRAWAL form to change all automatic withdrawals and automated payment services. Do not forget about

payments linked to your old debit card (such as automatic payments made on-line). Complete one form for EACH company making an automatic withdrawal. Be sure to attach a cancelled check from your new Timberline Bank Account with your form(s).

Register online at timberlinebank.com to start using our free bill pay for easy payments. #3 CLOSE

Close your old account(s). Close your old accounts by completing the AUTHORIZATION TO CLOSE ACCOUNT(S) form. This form will be sent to your former financial institution and will authorize them to close your existing accounts. Please remember to indicate whether you want your balance sent to you or Timberline Bank. If they are sent to Timberline Bank, we will deposit the funds directly into your new account.

Let Timberline Bank take care of the rest! Once you have finished all of your forms and are waiting for items to clear your account, simply return all completed forms to Timberline Bank, and we will do the rest. We will submit all of the completed forms to the appropriate businesses to ensure smooth and easy account transitions.

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PLEASE NOTE: ALL INFORMATION MUST BE PROVIDED BELOW INDIVIDUAL/BUSINESS NAME

SOCIAL SECURITY NUMBER(SSN)/TAX IDENTIFICATION NUMBER(TIN) DATE OF BIRTH

PHYSICAL ADDRESS

CITY STATE ZIP CODE

MAILING ADDRESS

CITY STATE ZIP CODE

HOME PHONE BUSINESS PHONE CELL PHONE EMAIL

DRIVERS LICENSE OR PASSPORT NUMBER STATE/COUNTRY OF ISSUE ISSUE DATE EXPIRATION DATE

PLEASE PROVIDE COPY OF IDENTIFICATION PASSWORD FOR ACCOUNT INQUIRIES

**THIS PASSWORD IS SPECIFIC TO EACH INDIVIDUAL. THE PASSWORD CAN BE LETTERS, NUMBERS, OR A COMBINATION OF BOTH.

THE INFORMATION I HAVE PROVIDED IS CORRECT AND I AUTHORIZE TIMBERLINE BANK TO VERIFY MY PAST BANKING HISTORY THROUGH CHEXSYSTEMS.

SIGNATURE DATE

BANK USE: BRANCH EMPLOYEE

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AUTOMATIC TRANSACTION INVENTORY CHECKLIST

DIRECT DEPOSITS

(LIST NAMES OF SPECIFIC INCOME SOURCE NEXT TO EACH CATEGORY)

COMPANY ACCOUNT NUMBER AMOUNT DATE

Employer(s) Payroll

Pension(s) / Retirement Plans Social Security

Investments Income Other

COMPANY ACCOUNT NUMBER AMOUNT DATE

Mortgage Auto Loans Insurance Credit Cards Gas/Oil Electric Cable/Satellite TV Phone Water Trash Internet Provider Health Club Investments IRA/Retirement Charities Daycare Other AUTOMATIC PAYMENTS

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COMPLETE THIS FORM FOR EACH AUTOMATIC DEPOSIT YOU WOULD LIKE TO CHANGE AND ATTACH A COPY OF NEW ACCOUNT CHECK.

NAME OF COMPANY MAKING DIRECT DEPOSIT ADDRESS

CITY STATE ZIP CODE

PLEASE STOP MAKING DEPOSITS TO THE FOLLOWING INSTITUTION, AS I HAVE CLOSED MY ACCOUNTS.

FINANCIAL INSTITUTION NAME ROUTING NUMBER STREET ADDRESS

CITY STATE ZIP CODE

I HEREBY AUTHORIZE MY DIRECT DEPOSIT TO BE SENT TO MY NEW TIMBERLINE BANK ACCOUNT(S). FOR REFERENCE, I HAVE ATTACHED A VOIDED CHECK FOR EACH ACCOUNT NOTED BELOW.

TIMBERLINE BANK:

ROUTING NUMBER: 102107063

DIRECT DEPOSITS INTO NEW ACCOUNT EFFECTIVE DATE FREQUENCY

NEW DIRECT DEPOSIT ACCOUNT INFORMATION

ACCOUNT NUMBER AMOUNT$ CHECKING SAVINGS ACCOUNT NUMBER AMOUNT$ CHECKING SAVINGS ACCOUNT NUMBER AMOUNT$ CHECKING SAVINGS

THIS AUTHORIZATION REPLACES ANY PREVIOUS AUTHORIZATION AND WILL REMAIN IN FULL FORCE AND EFFECT UNTIL THE COMPANY HAS RECEIVED WRITTEN NOTIFICATION FROM ME OF ITS TERMINATION IN SUCH TIME AND IN SUCH MANNER AS TO AFFORD THE COMPANY AND ITS BANK A REASONABLE OPPORTUNITY TO ACT ON IT.

CUSTOMER NAME PHONE

ADDRESS

CITY STATE ZIP CODE

AUTHORIZED SIGNATURE DATE

AUTHORIZATION TO CHANGE AUTOMATIC DEPOSIT

ASPEN | 720 EAST HYMAN AVE.

ASPEN CO, 81611

GRAND JUNCTION | 633 24 ROAD

GRAND JUNCTION, CO 81505

MONTROSE | 1561 OXBOW DR.

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COMPLETE THIS FORM FOR EACH AUTOMATIC WITHDRAWAL ACCOUNT YOU WOULD LIKE TO CHANGE. I HAVE CLOSED MY ACCOUNT WITH:

ROUTING NUMBER STREET ADDRESS

CITY STATE ZIP CODE

PHONE

I HEREBY AUTHORIZE AUTOMATIC PAYMENTS FROM MY NEW CHECKING ACCOUNT WITH:

TIMBERLINE BANK

AUTOMATIC PAYMENTS FROM NEW ACCOUNT EFFECTIVE DATE:

MY NEW TIMBERLINE BANK ACCOUNT NUMBER IS:

ROUTING NUMBER: 102107063

NAME OF BUSINESS TO RECEIVE FORM ADDRESS

CITY STATE ZIP CODE

DATE OR FREQUENCY OF PAYMENTS AMOUNT $

THIS AUTHORIZATION REPLACES ANY PREVIOUS AUTHORIZATION AND WILL REMAIN IN FULL FORCE AND EFFECT UNTIL THE COMPANY HAS RECEIVED WRITTEN NOTIFICATION FROM ME OF ITS TERMINATION IN SUCH TIME AND IN SUCH MANNER AS TO AFFORD THE COMPANY AND ITS BANK A REASONABLE OPPORTUNITY TO ACT ON IT.

CUSTOMER NAME PHONE ADDRESS

CITY STATE ZIP CODE

AUTHORIZED SIGNATURE DATE

PLEASE NOTE: IF THE INFORMATION PROVIDED IN THIS FORM IS NOT SUFFICIENT, PLEASE FORWARD AUTHORIZED COMPANY FORM FOR MY SIGNATURE.

AUTHORIZATION TO CHANGE AUTOMATIC WITHDRAWAL

ASPEN | 720 EAST HYMAN AVE.

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AUTHORIZATION TO CLOSE ACCOUNT(S)

CUSTOMER NAME PHYSICAL ADDRESS

CITY STATE ZIP CODE

MAILING ADDRESS

CITY STATE ZIP CODE

I HEREBY AUTHORIZE AND INSTRUCT THE FOLLOWING INSTITUTION TO CLOSE THE ACCOUNTS INDICATED. FINANCIAL INSTITUTION NAME

ADDRESS

CITY STATE ZIP CODE

PHONE

PLEASE CLOSE THE FOLLOWING ACCOUNT NUMBER(S)

ACCOUNT NUMBER CHECKING SAVINGS OTHER ACCOUNT NUMBER CHECKING SAVINGS OTHER

ACCOUNT NUMBER CHECKING SAVINGS OTHER

PLEASE SEND REMAINING BALANCE(S) TO THE CUSTOMER NAME AND ADDRESS LISTED ABOVE. PLEASE SEND REMAINING BALANCE(S) TO TIMBERLINE BANK

FBO

AUTHORIZED SIGNATURE DATE

ASPEN | 720 EAST HYMAN AVE.

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