F&M Switch Kit Forms - Farmers & Merchants State Bank

We make it Easy to Switch to F&M
Get started with the forms in our convenient switch kit
F&M Switch Kit Forms
1. Open Up a New F&M Account
2. Switch Direct Deposits
3. Switch Automatic Payments
4. Close Your Old Accounts
For help call 1.800.451.7843, visit any F&M
office location, or go to www.fm-bank.com
Member FDIC • Equal Housing Lender

New Account
Application
Please use this form to establish
your new account or apply online at
www.fm-bank.com.
Thank you for choosing Farmers and Merchants State Bank
Name ______________________________________________ Social Security Number _____________________________
Date of Birth (mm/dd/yyyy) ____________________________
Driver’s License Number _________________________________ State __________________ Exp. Date _______________
Street Address (required) _________________________________________________________ P.O. Box _______________
City ______________________________________________ State _______________ Zip _________ Rent ____ Own ____
Years at Current Residence _______________ (If less than 1 year, please provide previous address.)
Previous Address ______________________________________________________________________________________
Home Phone Number ____________________________________ Cell Phone _____________________________________
Work Phone Number ________________________________ Email Address ______________________________________
Employer ____________________________________________ Position ________________________________________
Mother’s Maiden Name ______________________________
For a joint account, please provide the following information for the additional account holder.
Name ____________________________________________ Social Security Number _________________________
Date of Birth (mm/dd/yyyy) ______________________
Driver’s License Number _______________________________ State _____________ Exp. Date _______________
Street Address (required) __________________________________________________P.O. Box _________________
City ________________________________________ State ______________ Zip ____________ Rent ____ Own ____
Years at Current Residence _______________ (If less than 1 year, please provide previous address.)
Previous Address ____________________________________________________________________________________
Home Phone Number _____________________________Cell Phone ________________________________________
Work Phone Number __________________________ Email Address _______________________________________
Employer ________________________________________ Position ___________________________________________
Mother’s Maiden Name ____________________________
Signature _________________________________________________ Date _________________________
Signature _________________________________________________ Date _________________________
To process this application, please drop it off at any convenient F&M location.
F&M Switch Kit
Member FDIC
1.800.451.7843 • www.fm-bank.com

Switch Direct
Deposits
This form authorizes an employer or other income
source to make deposits into your new F&M
account.
Attach a “Voided” personal check from your new F&M account. Do not sign the check.
Please complete one form for each automatic payment you wish to change.
To:
Employer/Depositor’s Name:
Employee Address:
City/State/Zip:
Employee ID Number:
I have opened a new account at Farmers & Merchants State Bank. Please direct my
Existing Direct Deposit
New Direct Deposit
to my new Farmers & Merchants State Bank account.
_____________________________________________________
Farmers & Merchants State Bank Account Number
Account type: Checking Savings
_____________________________________________________
041207341
Farmers & Merchants State Bank Routing Number
From:
Name:
Address:
City/State/Zip:
Social Security Number:
Telephone Number:
Signature ____________________________________________ Date ________________________
If you are unable to accept this form, please mail your authorized form to me at the above address.
F&M Switch Kit
Member FDIC
1.800.451.7843 • www.fm-bank.com

Switch Automatic
Payments
Use this form to notify a company of your request
to redirect your automatic payment to your new
F&M account.
Attach a “Voided” personal check from your new F&M account. Do not sign the check.
Please complete one form for each automatic payment you wish to change.
To:
Merchant Name:
Merchant Address:
City/State/Zip:
Merchant Account Number:
I have opened a new account at Farmers & Merchants State Bank. Please redirect my
Automatic Payment to my new Farmers & Merchants State Bank Account.
_____________________________________________________
Farmers & Merchants State Bank Account Number
Account type: Checking Savings
_____________________________________________________
041207341
Farmers & Merchants State Bank Routing Number
From:
Name:
Address:
City/State/Zip:
Social Security Number:
Telephone Number:
Signature _________________________________________ Date ________________________
If you are unable to accept this form, please mail your authorized form to me at the above address.
F&M Switch Kit
Member FDIC
1.800.451.7843 • www.fm-bank.com

Close Your
Old Accounts
Use this form to request that the account(s) you
have at your previous bank be closed and to have
any remaining funds sent to you.
Prior to closing your accounts, consult with your previous financial institution to determine
if there are any fees associated with closing your account. Please remember to keep enough
funds in your account until your last check has cleared. You may also visit your previous
bank to close out your accounts.
To Whom It May Concern:
Please close my bank account(s) listed below effective: Date: _____/______/______
Name(s) On Account:
Checking Account #:
Savings Account #:
Other Account #:
Other Account #:
Please send a check to me/us at the address listed below for any remaining funds in the
account(s).
Please contact me/us if you have any questions about this request.
Mailing Address:
City/State/Zip:
Telephone Number:
Signature _______________________________________________ Date ________________________
Signature _______________________________________________ Date ________________________
Thank you for processing this request immediately.
F&M Switch Kit
Member FDIC
1.800.451.7843 • www.fm-bank.com