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InfoLine Phone Transfer Request Agreement
Please
print this application, fill in the information requested below, sign
it, and mail to the referenced address below.
Town
North Bank
P.O. Box 814810
Dallas, TX 75381-4810
Attn: Data Operations
| ACCOUNT
NAME(S) |
ACCOUNT
NUMBER(S) |
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| CONTACT
PERSON(S) |
CONTACT
TELEPHONE NUMBER(S) |
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____________________________
Company / Individual (hereinafter referred to as "ENTITY")
maintains account(s) with Town North Bank (hereinafter referred to as
"BANK").
As an
authorized signer on the account(s) of the above referenced
"ENTITY", I and/or we, hereby authorize "BANK" to
allow the transfer of funds via the InfoLine integrated voice response
system (hereinafter referred to as "IVR") as follows:
| From "ENTITY's" acct # (s) |
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To "ENTITY's" acct # (s) |
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or vice
versa.
Also:
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- "ENTITY"
understands that they are responsible for the selection and safekeeping of
the InfoLine access code, and like any other security code, it should not be
written down, disclosed, or placed in any location that is accessible to
unauthorized parties.
- "ENTITY"
understands that "BANK" will never ask for the access code,
whether in person or by phone, and therefore can never disclose the access
code to someone that could be impersonating bank personnel or
"ENTITY".
- "ENTITY"
understands that the "IVR" will require "ENTITY" to
change the access code the first time the "IVR" is accessed, if
"ENTITY" has not already done so. At any access code change
request, the "IVR" will not allow the access code to match the
last four digits of the primary account holder’s social security number.
- "ENTITY"
understands that after three attempts to gain access to the "IVR"
with an invalid access code, "ENTITY" will be blocked from further
attempts and will be required to submit written authorization to allow
future access. At this point the access code will be reset to the last four
digits of the primary account holder’s social security number, and
"ENTITY" will select a new access code the next time the "IVR"
is accessed.
- "ENTITY"
understands that federal regulations restricts them to 6 (six) transactions
per month from a money market or savings account with no more than three by
check, draft, debit card, or similar order to a third party.
Whereas, on the
faith of the foregoing representations and "ENTITY" by placement of an
authorized signature below, hereby indemnifies "BANK" from any loss,
including but not limited to any costs or expenses incurred in connection
therewith, resulting from the transfer of monies held in these accounts. In the
event there is more than one party as "ENTITY", hereto all shall be
jointly and severally responsible for the above indemnity.
| Date: |
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Signature: |
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| Date |
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Signature: |
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(If
two or more signatures required)
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