ELECTRONIC STATEMENT REQUEST

Date

Customer Name

Account Information: Checking or Savings Only

Account Number Account Type
Account Number Account Type
Account Number Account Type

Email Address

Home Phone Business Phone

Cell Phone


I (customer) request that West Alabama Bank deliver my checking account statement to me electronically each statement cycle. I understand that I will receive email notification to the email address above notifying me that my statement is ready for retrieval through West Alabama Bank’s Internet Banking or Business Banking.

I also understand that the email notification will contain a link that will provide me a Statement Reconciliation Form, West Alabama Bank Locations and Telephone Numbers, and the proper disclosures for my account.

I acknowledge that electronic statement delivery will satisfy West Alabama Bank’s responsibility to provide me a periodic statement of my account.

I understand that if I change my email address, I must notify West Alabama Bank in writing or by email.
I also understand that I must be enrolled in Internet banking or Business Banking.