Apply for Farmers State Bank Bank ATM or Visa Check/Debit Card

In order to apply for a card for your account, please complete the form below. If your card has been lost or stolen, or if you have any questions about completing the application, please call our service center at (800) 554-8969.

General

Card Type ATM card (one savings account tied to card)
  Visa Check/Debit Card (one checking and one savings account tied to card)

Applicant

Checking Account Number
Savings Account Number
First Name
Middle Initial
Last Name
Suffix
Address
City
State
Zip Code
Birth Date
Home Phone Number - -
Social Security Number - -
Employer
How long?
E-mail Address

Authorization

By clicking on the "I Accept" box below, the applicant(s) request(s) the described services and agrees to the terms and conditions governing the services, including any fees and charges. The applicant(s) agree(s) that all information is accurate and authorizes the financial institution to verify credit and employment history, if necessary, by any means, including preparation of a credit report by a credit agency. Check the "I Accept" box to indicate that you (the applicant) have read the agreement and accept its terms.

I Accept

Important Disclosure for Personal Account Applications

I agree that I have read and agree to the following product Disclosures, Agreements, and Terms & Conditions:

I Agree Electronic Disclosure