• To enroll for NetTeller you must be a customer of Columbia National Bank.

  • Click here to review our products and services that we offer.

Applicant Information
Applicant Name
(including middle initial)
Co-Applicant Name  
Street Address  
City  
State   Zip Code  
Applicant Information Only
Home Phone
(including area code)
  Date of Birth
(mm/dd/yyyy)
 
SSN Number
or Tax ID Number
 
Email Address  

List below all accounts that you are a signer on and would like to be able to have NetTeller access to. List also the description you would like to use for each account you have selected. Examples of some account descriptions you might like to use: Checking, Savings, Car Loan, My Money, ect. No more than 20 letters or numbers can be used.

Account Number Account Description Allow Transfers
    Yes No
    Yes No
    Yes No
    Yes No
    Yes No
    Yes No
    Yes No

PLEASE READ BEFORE SUBMITTING YOUR NETTELLER APPLICATION

I understand that the NetTeller system allows me to transfer funds and make loan payments between the accounts listed above. I agree that my transfer requests may not exceed the account's available balance. I will repay any overdraft that may result from a transfer or payment request. I understand that the maximum number of transfers per statement cycle from an interest bearing account varies with the type of account. If that maximum number is exceeded the appropriate service charge will be assessed against my account.

I certify that the information provided is true and correct. I authorize Columbia National Bank to verify any information included in this application.