***For Office Use Only***
PLEASE READ BEFORE SIGNING I certify that the information provided is true and
correct. I authorize Progressive Ozark Bank, fsb. to verify any information
included in this application and allow access to all accounts I may be a signer
on listed above. The use of Progressive Ozark Bank's internet banking system
shall be governed by the printed terms and conditions or amendments thereto, as
may be established by Progressive Ozark Bank, fsb. and communicated in writing
to me.
PLEASE READ BEFORE SIGNING If I use Progressive Ozark Bank's Internet Banking
Bill Payment Service, I understand that I will be responsible for determining
the payee of such payments, the scheduled pay date, the primary account to be
used for bill payments, and the availability of funds in my account. I
understand that any payment made without sufficient funds in my account could
be returned. My account will be charged overdraft fees, and this may result in
suspension of bill paying privileges. I also understand that electronic bill
payment may take the form of a check issued by Progressive Ozark Bank, fsb. and
may take up to 10 days to reach the payee. Progressive Ozark Bank, fsb. is not
liable for late charges or other penalties associated with late receipt of my
payment by the payee. I authorize Progressive Ozark Bank, fsb. to debit my
account number ____________________ for all Internet banking bill payments and
fees. If at any time I desire to discontinue Internet Banking Bill payment, I
may do so upon written notification to Progressive Ozark Bank, fsb. at 904 W.
Scenic Rivers Blvd P.O. Box 279, Salem, MO 65560, ATTN: Account Services Dept.
I will protect my Internet Banking Bill Payment User ID and password with the
same security as any other account access service or PIN.
The Undersigned agrees to the same terms stated above.
Signature ___________________________________
Date ________________________________
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