Business Online Banking Application

Business Online Banking Application¹
(Primary Services)

SECTION I. BUSINESS INFORMATION
* Primary Company Name:
* Mailing Address:	* Business Tax ID: EIN SSN
* City: * State: * Zip: * Business Phone: Fax: * E-Mail:	* Business Type Corporation Limited Liability Company (LLC) Unincorporated Association Limited Liability Partnership (LLP) Sole Proprietorship Partnership Other
* Describe the Type/Nature of the Business:	* Describe of the Products or Services Sold:

SECTION II. ONLINE BANKING SERVICES REQUESTED²
Business Online Banking (OLB) Business Online Banking includes the following services: Access to accounts, view check and deposit slip images, and initiate internal fund transfers, internal Multi-TIN transfers, internal loan payments and stop payments.
I would like to enroll in Bill Pay Bill Pay Service includes the following services: Pay bills online, set-up payees and vendors, schedule future-dated or recurring payments, include invoice and/or memo information on each ��check�� payment, create e-mail reminders, obtain payment history, and generate custom summary and detail reports.

SECTION III. PRIMARY ADMINISTRATOR
* Primary Administrator² Name:	* SSN:	* Title:
* E-mail Address:	* Cell Phone:	Fax:
* Mother's Maiden Name:	* DOB:
²The Primary Administrator is the primary user of the online banking system and has rights to all accounts and services indicated on this application.

SECTION IV. AUTHORIZED USERS³

Authorized User Name:

SSN:

Title:

E-mail Address:

Cell Phone:

Mother's Maiden Name:

DOB:

Authorized User Name:

SSN:

Title:

E-mail Address:

Cell Phone:

Mother's Maiden Name:

DOB:

³The Primary Administrator is responsible for creating Authorized Users (if desired) and assigning users' rights. The Primary Administrator understands and agrees to obtain Bank Approval prior to adding any additional Authorized Users. Failure to obtain Bank Approval may result in the suspension of access by the Authorized User or suspension of Online Banking Services.

¹Business Online Banking services are subject to approval by the Bank. Limits on usage and amounts apply.

SECTION V. LINKED ACCOUNTS⁴
Business Name	Account Number	Business Tax ID	Billing Account⁵








*Additional accounts may be added after approval of Online Banking Services.* ⁴By electronically signing this application, each of the Customers of the different accounts specified above authorize Multi-TIN transfer capabilities to and from each of the accounts specified above. Customers authorize access to all accounts as specified above from one main log-in account using the Business Online Banking service and understand and agree to the terms and conditions provided in the Business Online Banking Agreement and Disclosure (the "Agreement"). ⁵Unless otherwise indicated above, the first account listed above will serve as the Billing Account for this Business Online Banking profile. This account will be assessed any fees (if applicable) related to online banking services, unless otherwise indicated under separate agreement.

SECTION VI. CUSTOMER AUTHORIZATION

	* Each Customer represents to Cross County Savings Bank ("Bank") and acknowledges that the information provided in this application is true and correct as of this date and Customer has not omitted any pertinent information nor committed any intentional or negligent misrepresentation of the information contained in this application. Customer further acknowledges that this application and any agreement referred to herein has been duly and validly authorized, executed and delivered by the Primary Administrator and/or Authorized User on behalf of the company, association or organization identified below; and that this application and any agreement referred to herein constitutes the legal, valid and binding obligation of the company, association or organization identified below, enforceable in accordance with its terms. All actions and proceedings required for the execution and delivery of this application and any agreement referred to herein, and for the consummation of the transactions contemplated hereby, have been duly taken.
	* Each Customer agrees to pay Cross County Savings Bank the charges, if any, for Business Online Banking services set forth in the Bank's Fee Schedule, as well as any additional charges that may be incurred from the Bill Pay provider for use of such service. All fees and services are subject to change by Bank upon thirty (30) days prior written notice. Such charges do not include, and Customer shall be responsible for payment of, any sales, use, excise, value added, utility or other similar taxes relating to such services, and any fees or charges provided for in the depository agreement between Bank and Customer with respect to the account. Each Customer shall also be responsible for any and all telephone access fees and/or internet service fees that may be assessed by its telephone and/or internet service provider.
	* Each Customer has read and accepts and agrees to all terms, conditions, and provisions of the Business Online Banking Agreement and Disclosure and agrees that this Agreement sets forth the terms and conditions pursuant to which the Bank will provide Customer with the services outlined herein. Customer's initial sign-on and, if applicable, Customer's later enrollment in Bill Pay, ACH Origination and/or Wire Transfer services, each constitute Customer's Electronic Signature and will be binding upon Customer as its legal signature. Each time Customer uses its User ID and Password, it shall also constitute its binding Electronic Signature and agreement to the terms and conditions of the Business Online Banking Agreement and Disclosure. Customer expressly acknowledges and represents that Customer has been given a full and fair opportunity to review the Business Online Banking Agreement and Disclosure with an attorney of its choice, and that to the extent, if any, that it desired, Customer availed itself of this right. Customer further acknowledges and agrees that Customer has carefully read and fully understands all of the provisions of the Business Online Banking Agreement and Disclosure and that Customer is hereby voluntarily and knowingly entering into the Business Online Banking Agreement and Disclosure, which terms and provisions Customer finds to be reasonable and enforceable.

PLEASE COMPLETE THE SECTION BELOW FOR EACH CUSTOMER/BUSINESS THAT WILL BE ENROLLED IN BUSINESS ONLINE BANKING.

* Business Name:
* Printed Name:
* Title:
* Business Tax ID:
* Date:

Business Name:
Printed Name:
Title:
Business Tax ID:
Date:

Business Name:
Printed Name:
Title:
Business Tax ID:
Date:

Business Name:
Printed Name:
Title:
Business Tax ID:
Date:

Business Online Banking Application1 (Primary Services)

Business Online Banking Application¹
(Primary Services)