Savings Round-Up

Please enroll me in the Savings Round-Up program. I realize whenever the debit cards attached to my checking account are used for purchases, it will automatically round those up to the next dollar amount and a daily total will be transferred from my checking account to the savings account indicated below. I am aware that my request will be active until I notify NPB to stop the automatic transfer.

Information

First Name Middle Initial Last Name DOB Last 4 of Social Security Number Last 4 of Checking Account Number Last 4 of Savings Account Number Savings Account Name(s) Referring Employee Name Referring Branch Name

Authorization

Terms and conditions:

Round Up transfers only apply to Debit Card purchases.
Any purchase(s) made after you enroll will be included in the Savings Round Up Program.
If there are not enough funds to cover the full transfer from your Checking Account, no transfer will be made. Savings Round Up will not utilize any overdraft source, including Lines of Credit.
If your debit card purchase is subsequently cancelled or reversed, the corresponding Savings Round Up transfer remains in your Savings Account.
All debit cards associated with the Checking Account selected will be enrolled in the Savings Round Up Program.

By submitting this form, I hereby state that I have read and understand the Savings Round Up terms and conditions.

Yes, I agree to the Terms and Conditions Electronic Signature Date

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