Personal Online Banking
Enrollment Form

To sign up for Internet Banking, complete and hit "submit" or print the application. If printing, sign the form and send it to Wayne Bank and Trust Co. via US mail, fax or hand deliver to any Wayne Bank and Trust Co. location.

Once the form is returned to us, you will receive a letter with information and instructions to begin using Online Banking via US mail.

Business customers please contact the bank at 1-888-769-2963 to find out how to sign up for Commercial Online Banking.

Customer Information:

First Name:

 

Last Name:

 

Address:

 

City:

 

State:

 Zip: Phone:

E-Mail:

 

Social Security Number:

 

Primary Checking Acct. #:

 

Requested Services:

 

 

Internet Banking

 

 

Bill Payment

 
 

Access account balances, transfer money, and conduct common banking tasks online.

 

Pay bills on-line. Pay any individual or company.  Free for our Advantage, Premium and Golden Eagle 50 Checking accounts up to 10 bill pays a month, $.60 ea. thereafter. First 3 months free for our Direct Checking accounts, $4.95/month thereafter.

 

Account Information:

Account Number and Access Type*:

Account Description, as you identify this account:

 

1)

 

2)

 

3)

 

4)

 

5)

 

6)

 

7)

 

8)

 

*** Definitions for Access Types:

  • Full Access - You will have the full access available on this account.
  • View & Deposit - You may view account information and transfer funds into this account.
  • View Only - You will be able to view balances and transactions.
  • Deposit Only - You will be able to transfer funds into this account from other accounts with Full Access. You will not be able to view balance or transaction information.

**Please Note: You must be an authorized signer on each of these accounts

Agreement & Certification: I am applying To Wayne Bank to establish an Online Banking Service relationship and if approved, I authorize Wayne Bank to process electronic transactions as requested on my behalf and post them to the account(s) that I designate on this application.  I agree that my first use of the Online Banking Service will signify my acceptance of the terms and conditions as provided to me within the Online Banking Service Agreement (at the time of Online Banking Service application).  I agree that the Bank is not responsible or liable for any unauthorized transfer from an account due to the failure by myself or any authorized person to maintain the security of the User ID and or Password.  I certify that I have not altered this form, and in the event of any alterations, the terms of the original version will prevail.

Terms and Conditions - YOU MUST READ BEFORE SUBMITTING THIS FORM

Applicant Signature:       Date: 

Joint Applicant Signature:     Date: