Direct Connect Enrollment

Choose a product:*

Primary Account Number:*

(Account all bill payments are deducted from; primary account enrolled must be a checking account)

Additional Accounts

Please add additional accounts you would like included in this enrollment.

Last Four Digits of Your Social Security or Tax ID Number:*

(Enter Social Security Number for personal use, Tax ID Number for business use.)

Business Name:*

Customer Name:*

E-mail Address*

Contact Number

New code

Please type the code above

Please note: Direct Connect enrollments are subject to bank review and approval.