FNB Bank, Inc. 101 East Broadway Mayfield, KY 42066
Direct Deposit Change Request
Date:
Phone:
Social Sec#
To:
Address:
City:
State:
Zip:
From:
RE: Change of Direct Deposit Routing
To Whom It May Concern:
Effective immediately, please change my direct deposit(s) as listed below to go to my new bank, FNB Bank. FNB Bank's routing information is listed below. If you require further information from me, please contact me at the address and/or phone number listed above. Thank you for your prompt attention to this matter.
Existing Direct Deposit(s) - Please discontinue
Bank Name
Account # Checking Savings
Please begin sending my deposit(s) to FNB Bank.
Bank Name: FNB Bank, Inc. Mayfield, KY Bank ABA# 083901087
New Deposit Instructions
Deposit the entire amount to checking account number:
Deposit the entire amount to savings account number:
Deposit $ to account number:
and the remainder to account #
I authorize:
___________________________________ ______________________________
Signature of account holder Date
__________________________________
Second Signature (If Joint Account)
Print this form out first then sign and date and return to us at:
FNB Bank, Inc.
101 East Broadway
P.O. Box 369 Mayfield, KY 42066-0029