First State Bank of Red Wing
First State Bank of Red Wing Online Banking Enrollment Form
*Required Fields
Login Information
Please select Login-ID between 4-25 characters. It may contain all letters or a combination of letters and numbers, and special characters; it is case-sensitive and cannot contain spaces. Please select a Login-ID that you can remember as you will use this Login-ID once your account is activated.
Desired Login ID*:
Customer Information
Please provide at least one email address and one phone number to receive your secure access code for your Online Banking login. You will be required to set your password after entering your secure access code.
Please indicate how you wish to use Online Banking: Personal    Business
First Name*: Middle Initial:
Last Name*:
Company Name:
SSN*:    
Address*:  
Address:
City*:  
Zip Code*:
Home Phone*: Work Phone:  
Mobile Phone:  
Email Address*:  
Security Information
Please fill out this information section for security verification.
Date of Birth*:  
Mother's Maiden Name*:  
Date of Last Deposit*:  
Amount of Last Deposit*:  
 
Account Number* Account Type
Please provide the Account Number(s) that you wish to access through Online Banking. All accounts must have the same ownership as the information provided in the Customer Information section above.
Signature and Disclaimers
This document is being secured with SSL encryption provided by your browser. Your information will be encrypted when using this form while in transit between your browser and First State Bank of Red Wing.
*Signature: *Date:
  (Type your full name)   (Today's Date)
        
 
Member FDIC
Member FDIC
First State Bank of Red Wing

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