The Bank of Mauston - Switch Kit

Member FDIC | Equal Housing Lender
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Switch Kit

Submitter Information

First Name (required)

Last Name (required)

Resolve the errors marked in red before submitting again.

	Name

Street Address

Street Address Line 1

Street Address Line 2

City

State

ZIP Code

Mail Address if different

Street Address Line 1

Street Address Line 2

City

State

ZIP Code

	Home Phone	Work Phone	E-mail Address

	Name

Street Address

Street Address Line 1

Street Address Line 2

City

State

ZIP Code

Mail Address if different

Street Address Line 1

Street Address Line 2

City

State

ZIP Code

	Home Phone	Work Phone	E-mail Address

	Date of Birth

	Alternate Access Code	Employer	Position

	Date of Birth

	Alternate Access Code	Employer	Position

I would like to open

Personal Checking

Business Checking

Money Market

Statement Savings

IRA

I/we would like an ATM/CheckCard

I/we would like transfer capabilities at the ATM and online.

I/we would like free online access to account(s).

Number of ATM/CheckCard Cards

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