Print Check Card Application PDF Form

Check Card Application

* indicates a required field

Primary Applicant

*Name (First Last)
*Address
*City, State Zip ,
*Home Phone Number ( ) -
*Social Security Number
*Date of Birth (mm/dd/yyyy)
*Mother's Maiden Name
*Employer *# of Years
*Primary Account # your Card will Access
*Email Address

Co-Applicant

*Name (First Last)
*Address
*City, State Zip ,
*Home Phone Number ( ) -
*Social Security Number
*Date of Birth (mm/dd/yyyy)
*Mother's Maiden Name
*Employer *# of Years



By checking this box, I/we request the described services and agree to the terms and conditions governing the services, including any fees and charges. I/we agree that all information is accurate and authorizes Coleman County State Bank to verify credit and employment history by and any necessary means, including preparation of a credit report by a credit reporting agency. I have received the fee and disclosure statement for the Check Cards.

What You Need to Know about Overdrafts and Overdraft Fees

An overdraft occurs when you do not have enough money in your account to cover a transaction, but we pay it anyway.
We can cover overdrafts in two different ways:

  1. We have standard overdraft practices that come with your account.
  2. We also offer overdraft protection plans, such as a link to savings account, which may be less expensive
    than our standard overdraft practices. To learn more, ask us about these plans.

This notice explains our standard overdraft practices.

> What are the standard overdraft practices that come with my account?

We do authorize and pay overdraft for the following types of transactions

  • Checks and other transactions made using your checking account number
  • Automatic bill payments

We do not authorize and pay overdrafts for the following types of transactions unless you ask us to (see below):

  • ATM transactions
  • Point of Sale debit card transactions

We pay overdrafts at our discretion, which means we do not guarantee that we will always authorize and pay any
type of transaction.

If we do not authorize and pay an overdraft, your transaction will be declined.

> What fees will I be charged if Coleman County State Bank pays my overdraft?

Under our standard overdraft practices:

  • We will charge you a fee up to a $25 each time we pay an overdraft.
  • There is no limit on the total fees we can charge you for overdrawing your account.

> What if I want Coleman County State Bank to authorize and pay overdrafts on my ATM and Point of Sale debit card transactions?

If you also want us to authorize and pay overdrafts on ATM and Point of Sale debit card transactions, contact any of
our account representatives at 325-625-2172 or 325-692-8660, visit www.colemanbank.com. Or complete the form
below and present or mail it to our main bank or our branch.

P.O. Box 940, Coleman, Texas 76834 Or P.O. Box 6483, Abilene, TX 79608.

I DO NOT want Coleman County State Bank to authorize and pay overdrafts on my ATM and Point of Sale debit card transactions
I WANT Coleman County State Bank to authorize and pay overdrafts on my ATM and Point of Sale debit card transactions

    

 

Print Check Card Application PDF Form