Plains State Bank

Apply for a Plains State Bank ATM or Visa Debit Card

In order to apply for a card for your account, please complete the form below (all fields in bold are required). If your card has been lost or stolen, or if you have any questions about completing the application, please call our bank at 620-563-7242.

General

Card Type ATM Card      Visa Check/Debit Card

Applicant

Account Number
First Name
Middle Initial
Last Name
Suffix
Address
City
State
Zip Code
Daytime Phone Number - -
Home Phone Number - -
Social Security Number - -
Birth Date
Mother's Maiden Name
E-mail Address
  Please do NOT email me important news and updates.
How would you prefer to be contacted? Home Phone
Work Phone
Email
Other

Authorization

By clicking on the "I Accept" button 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" button to indicate that you (the applicant) have read the agreement and accept its terms.

Terms and Conditions


I Accept