Business Online Banking Enrollment Form
    * denotes required field
Authorized Signer Information
Application must be submitted by an owner on all accounts for the business.
Please provide phone numbers and email addresses for security code delivery.
Business Name:* TIN:*
Business Address:*  
Business City:* Zip Code:*
Business Phone#:*
Owner's First Name:* Last Name:* Middle Initial:
Owner's Address:*  
Owner's City:* Zip Code:*
Date of Birth:*
Home Phone#:* Work Phone#:*
Email Address:*
User Name / Login ID
Please enter your desired User Name. Your User Name can contain up to 15 characters consisting of letters, numbers and symbols. Each customerís User Name must be unique. If the User Name you have requested is not available,
Planters Bank will provide a similar but alternate User Name for you.
Preferred User Name/Login ID:*
Account Access Information
Please provide the Account Number and Account Type for each account that you wish to access using Online Banking. All accounts must have the same ownership as the information provided in Owners Information above.
Account Number Account Type
How did you hear about our Online Banking?
Please let us know how you heard about us.
Signature & Disclosures
Online Banking Agreement and Disclosure: Please click here to review our Online Banking Agreement and Disclosure.
Signature:* Date:*
By entering my name above and clicking the Submit Enrollment button, I certify that I have reviewed and accept the terms in the Online Banking Agreement and disclosure