"Checks for Less" Order Form

Please fill out all fields and use the Submit button at the bottom of the form to transmit your application. This form is secured using Verisign digital certificate encryption for your protection.

Use this form to order checks from "Checks 4 Less" only.
Thank you.

Please fill out the information below and we will gladly process your order. As with all check orders, your checking account will be automatically debited.

Checks should arrive in the mail in 7-10 business days. If you do not receive your checks within that time or if you have any questions, please contact Farmers & Merchants Union Bank.

Personal Information
Name:
Joint Owner Name:
Address:
City:
State:
Zip:
E-mail:
Home Phone Number :
Checking Account Number:
Which style would you like:
How many boxes would you like?
I would like: Single checks or Duplicate checks
Would you like your phone number to appear on your checks?	Yes No
If you would like your driver's license number on your checks, please provide that for us here:
What number would you like your checks to start (or continue at:(0-9000):	*Optional
Questions or comments?

Farmers & Merchants Union Bank is participating in the FDIC's Transaction Account Guarantee Program. All funds in a “noninterest-bearing transaction account” are insured in full by the Federal Deposit Insurance Corporation from December 31, 2010, through December 31, 2012. This temporary unlimited coverage is in addition to, and separate from, the coverage of at least $250,000 available to depositors under the FDIC’s general deposit insurance rules. The term “noninterest-bearing transaction account” includes a traditional checking account or demand deposit account on which the insured depository institution pays no interest. It also includes interest on Lawyers Trust Accounts (“IOLTAs”). It does not include other accounts, such as traditional checking or demand deposit accounts that may earn interest, NOW accounts, and money-market deposit accounts. For more information about temporary FDIC insurance coverage of transaction accounts, visit www.fdic.gov.

"Checks for Less" Order Form

Personal Information