INTERNET BANKING ACCESS IS REQUIRED FOR ESTATEMENT. If you do not currently use internet banking, enroll here before completing this enrollment.

REQUIREMENT
You must test your computer's ability to open a SAMPLE STATEMENT, which is in the same format as your actual e-Statement will be. Please click on this SAMPLE STATEMENT link. A statement should come up within less than a minute (depending on your Internet Connection speed). If you are unable to open the sample statement, verify your computer has Adobe Acrobat Reader version 4.05 or higher installed. If not, it may be downloaded from Adobe's website, or from the link below, then try to open the sample statement again. If you need assistance, call 1-866-733-3444 during business hours.

GET ADOBE READER

Yes, I am able to open and view the sample statement.

Location*

First Name*

Last Name*

Email Address*(Primary Account holder)

FF&M Bank does not release e-mail addresses to any third party or use for marketing solicitations.
Re-Enter Email Address*

Accounts To Enroll
If your savings account is included on your checking statement it will automatically be enrolled for e-Statement. To enroll more than three accounts, please complete an additional enrollment form.
Account Type*

Account Number*

Account Type

Account Number

Account Type

Account Number


PLEASE READ BEFORE SUBMITTING E-STATEMENT AGREEMENT
By accepting this agreement you consent and agree to receive disclosures (periodic statement, notices, and other applicable disclosures) electronically and will no longer receive them by paper. All future disclosures will be electronic unless you revoke consent by giving First Farmers & Merchants Bank written notice of such revocation at which time you will be converted back to paper at a $10.00 charge. We require a minimum of 5 business days to convert from electronic disclosures to paper disclosures.

In order to receive electronic disclosures, you must provide us with your e-mail address. If you change your e-mail address, you must notify us of the change in order to receive future electronic disclosures. If any e-mail notifications are returned undeliverable, we will attempt to contact you by phone to obtain your current e-mail address. If we are unable to contact you by phone, we will mail you a paper statement. If by the following month's statement you have not notified us of your correct e-mail address, you will automatically be removed from the electronic disclosure process.

You have the right to receive a paper copy of any of your periodic statements we have sent you electronically. To request a paper copy of a statement for a $2.00 charge, call, write, or e-mail your local First Farmers & Merchants Bank.

In order for you to access and retain electronic statement records, your computer system must meet the following requirements:
• Internet Access
• Internet Browser
Internet Explorer version 5.5 or higher or
Netscape Navigator version 4.05 or higher
• Adobe Acrobat Reader version 4.05 or higher
• Means of permanent statement storage (storage device such as hard drive, removable disk, or ability to print)

Once we have processed your enrollment request to receive electronic statements, we will send you an acknowledgment e-mail to the address you indicated above within 2 business days. If you DO NOT receive this e-mail, you must contact tech support at 1-866-733-3444 to report the e-mail problem.

Yes, I have read and agree to the e-Statement agreement.



FDIC
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