eStatements

Save time and save a tree - have your monthly statement delivered electronically!

Sign up for our FREE estatements and go paperless. You will receive an e-mail to let you know your statement is ready and you can view or print your statement right out of Internet Banking.

Please provide all the requested information. When you have completed the form, press the Submit button to send your form to Farmers & Merchants Union Bank. This form is secured using Comodo digital certificate encryption for your protection.

All our forms are completely secured. However, if you prefer, you may print this form out and mail or fax it to us. You may also drop if off at one of our convenient locations.

Farmers & Merchants Union Bank
Attn: IT Department
P.O. Box 226
Columbus, WI 53925

Or via Fax to 920-623-4010

Please Note: For security purposes, you will receive a phone call from our Bookkeeping Department to verify the information on this form. All future statements will be received electronically until cancelled. If you have any questions, please contact us at 920-623-4000 ext. 8350.

New Enrollment		Cancel Enrollment
Change Email Address		Add Accounts
Personal Information:
Name of Account Owner 1:
Social Security Number - Account Owner 1:
Name of Account Owner 2:
Social Security Number - Account Owner 2:
Daytime Phone Number: We will call you to confirm this change.
Email Address:		*
Account Information:
Checking Savings Account Number
Checking Savings Account Number
Checking Savings Account Number
Checking Savings Account Number
(Passbook Savings Accounts are not eligible for E-Statements unless on Combined Statement)

You may also print this application and mail it or stop by one of our locations.

Please Note: By submitting this form you are certifying under penalties of perjury that you are the above named person within this document, that you are an owner on the account(s) listed above and that the email address listed above is your email address.

Enrollment for the electronic statement service requires you to have access to a personal computer, which permits you to access the email account listed above. By completing and clicking on the Submit button below, you are authorizing Farmers & Merchants Union Bank to email you that your statement is ready for you to view online. By choosing this, you will not receive paper copies of those statements. All regulations and consumer protection acts applying to paper statements will also apply to statements received via electronic means. After you enroll, you can always terminate your enrollment and stop receiving your statement electronically by notifying Farmers & Merchants Union Bank via this electronic form or by sending notification to the address listed below. There is no fee to cancel your enrollment and you will then begin receiving paper copies of your statements again. You will be charge in accordance with our fee schedule for any additional copies. If you have any questions regarding any statement that has been sent to you electronically, you can contact us at 920-623-4000 during normal business hours or by mail by writing to: Farmers & Merchants Union Bank P.O. Box 226 Columbus, WI 53925

Farmers & Merchants Union Bank is participating in the FDIC's Transaction Account Guarantee Program. Under the program, through December 31, 2010, all noninterest-bearing transaction accounts are fully guaranteed by the FDIC for the entire amount in the account. NOW accounts paying a higher rate of interest will not be eligible for the additional coverage under the program. Coverage under the Transaction Account Guarantee Program is in addition to and separate from the coverage available under the FDIC's general deposit insurance rules. On May 20, 2009, FDIC deposit insurance temporarily increased from $100,000 to $250,000 per depositor through December 31, 2013.