FSCB FirstNet Internet Banking
Consumer Account Application
Internet Banking is free for personal accounts.
Business account customers will pay a fee.
Call your local branch for information. Please print and either mail or fax to your
First State Community Bank branch location. (Click on the locations page for locations and phone numbers.)
YES! Enroll me in FirstNet, FSCB's Internet Banking Account (FREE)
ID # 7183
YES! Enroll me in the bill-pay service through FirstNet, FSCB's Internet Banking Account (Bill Pay is FREE)
Today's Date
Applicant #1 Information (Primary Account Holder)
Mr./Mrs./Ms/Dr.
First Name
Middle
Last Name
Address:
City:
State:
Zip:
Home Ph.( )
Work Ph. ( )
Email
Applicant Social Security #
Co-app. Social Security #
Mother's Maiden Name
Mother's Maiden Name
Do you currently have a First State Community Bank account?
Yes
No
If No, best time to call:
AM
PM Where?
Home
Work
First State Community Bank Account Information List accounts below for Internet Banking. Use up to 26 characters to identify your account. Do not use punctuation. Spaces may be used.
Actual Account #
To Be Known As (Alias)
12345678 (example)
To be Known As (Alias) My Checking (example)
34567890 (example)
To be Known As (Alias)
Home Loan (example)
To be Known As (Alias)
To be Known As (Alias)
To be Known As (Alias)
To be Known As (Alias)
To be Known As (Alias)
To be Known As (Alias)
I (We) the undersigned certify that the information provided is true and correct. I (We) authorize First State Community Bank (the bank) to verify any information included in this application and allow access to all the accounts listed above that I (We) may be a signer on. I (We) understand that the use of this service is subject to the terms and conditions of the FirstNet/ Bill-pay Electronic Funds Transfer Agreement and Disclosure Statement provided upon implementation. I (We) understand that subscribing to this service, or permitting another to use this service, constitutes acceptance of the terms and conditions of the FirstNet/Bill-pay Electronic Funds Transfer Agreement and Disclosure Statement.
