Business Internet Banking
Online Enrollment and Additional Services Request

Business Internet Banking Enrollment and Additional Services Request
Please complete the information below to enroll in Business Internet Banking, add additional accounts to your Internet Banking access, add the ability to enroll in Online Bill Pay, and enroll in Electronic Statements. Once your request has been processed, you will receive instructions to access Internet Banking, Online Bill Pay, and Electronic Statements.
Business Information
Business Name:
Address:
City:
State:        Zip: Phone:
Primary Business E-Mail:
Business Tax ID:
Primary Business Account #:
Business Account Owner or Authorized Signer Information
Full Name:
Driver's License / ID #:
Last 5 Digits of Social (SSN):
Date of Birth: (MM/DD/YYYY)
User Information
Full Name: Login ID: User Email Address: Supervisor / Administrator:
1
2
3
4
5
6
7
8
More than 8 users: Please submit an additional enrollment request.
Account Information & User Access
Account Number: Account Type: User Access Level:
User 1 User 2 User 3 User 4 User 5 User 6 User 7 User 8
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
More than 15 accounts: Please submit an additional enrollment request.
Checking: Full Access (Full) Money Market (Money Mkt): Full Access (Full)
Savings: Full Access (Full) Christmas Club (C-Club): View & Deposit (V&D)
Time Deposit / Individual Retirement Account (TD/IRA): View Only (View)
Loan: View & Deposit (V&D) Line of Credit (LOC): View & Deposit (V&D)
Definition of User Access Levels:
Full Access (Full): Allows full access on this account (view, transfers in, transfers out).
View & Deposit (V&D): View account information and transfer funds into this account.
View Only (View): View balances and transactions.
Deposit Only (Deposit): Transfer funds into this account.
Additional Services
Business Online Bill Pay* Selecting the box to the left will activate the ability to enroll in Online Bill Pay.
Electronic Statements* (e-Statements) Selecting the box to the left will activate e-Statements.
In the box below, please type the code as seen on the left.
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Business Services Questionnaire
1. Will you initiate two or more wires a month?
2. If Yes, would you like to initiate wires through Internet Banking?
3. Do you intend to pay your employees through Direct Deposit?
4. Do you intend to debit your customers electronically on a recurring periodic basis?
5. Do you make two or more deposits a week?
6. If Yes, would you like to make deposits from the convenience of your office?
Acknowledgement and Acceptance
Please Note:
  • You must be an ACCOUNT OWNER or AUTHORIZED SIGNER on each of the accounts listed above.
  • All customer information listed above will be verified / validated against the records of United Community Bank.
  • All Accounts, Users, and corresponding User Access will be granted as shown above.
By selecting Business Online Bill Pay; I certify I have read, understand, and agree to all terms and conditions as outlined in the United Community Bank Business Internet Banking Service Agreement and Disclosure (including any applicable Online Bill Pay fees) and the Terms and Conditions of the Online Bill Pay service.

By selecting Electronic Statements; I certify I have read, understand, and agree to all terms and conditions as outlined in the United Community Bank e-Statement Agreement and Disclosure.

I acknowledge receipt of and accept the terms of the United Community Bank Business Internet Banking Service Agreement and Disclosure. It is resolved that United Community Bank is authorized to grant the persons listed above access as users of United Community Bank's Business Internet Banking on behalf of the company, per a resolution adopted by the Board of Directors of the Company. I certify that I am the owner or authorized signer/representative for the Company, and as such, I am authorized to enter into this agreement on behalf of the Company. I agree that confidentiality of a User ID and Password is the responsibility of the each user. I agree to promptly review the account activity and notify United Community Bank of any errors. Users with "Supervisor" rights are responsible for monitoring and administering the access of other Users. United Community Bank is not liable for errors that may result from failure of the "Supervisor" to properly administer the accounts and/or properly control their password. I agree to receive important regulatory information via an electronic medium, which can be printed or downloaded for future reference. I understand that United Community Bank will verify the information provided in this request against the records of the Bank. Any information on this request that is not correct, per the records of United Community Bank, will cause this enrollment request to be rejected by the Bank. If I need assistance, I may contact United Community Bank at (225) 644-2265.

By clicking "I Accept", I certify all information provided is accurate, I agree to all terms and conditions outlined and referenced herein, and authorize United Community Bank to process my request as stated above.

Date: (MM/DD/YYYY)