DIRECT CONNECT ENROLLMENT FORM
(COMMERCIAL)
Customer Name:
_________________________________ ____________________
Contact Name:
__________________________________________________
Phone Number:
Fax Number: _______________________
E-mail Address:
_________________________________________________________
Tax ID:
____________________________________________________________
Administrator Name:
_____________________________________________ _____________
Existing Netteller ID
______________________________ _____________________
(located on Customer CIF record)
NEW SETUP
MAINTENANCE TO EXISTING ONLINE SETUP
(Customer signature is not re quired for Maintenance)
Please indicate the type of request , account number(s) and functions:
Add or Delete
User’s Full Name
Account Name
Account Number
Functions A-K
(listed below)
List of Direct Connect Functions:
A. Balance/Transaction Inquiry
G. Wire Transfer Initiation*
B. Bank Statements
H. ACH Initiation*
C. Download Capability
I. Positive Pay*
D. Stop Payments
J. Line of Credit Reporting
E. Account Transfers
K. Line of Credit Payments
F. Bill Payment
*Additional documentation is required.
Wire Transfer Initiation (if applicable)
Company Limit: $______________________
ACH Initiation (if applicable)
Company Limit: $ __________
Bank will furnish to Customer the initial I D and PIN. Bank advises changing the initial ID and P IN. The
Administrator must assign authorized users and must assign specific bank accounts and services to authorized
users. Bank will assume that any access to Stonegate Bank Direct Connect with the Customer's ID and PIN is
made by an authorized user. Customer agrees and will convey to the authorized users the importance of
10/08 Stonegate Bank Direct Connect Enrollment/Maintenance Form
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ensuring the security of ID and P INs in order to assure the authenticity of attempts to acces s information
initiated via Stonegate Bank Direct Connect. It is the responsibility of the Customer to immediately delete any
Online Banking user that is no longer a uthorized to access Stonegate Bank Direct Connect . Bank will not
assume responsibility for removing unauthorized users from Stonegate Bank Direct Connect . It is the
responsibility of the Customer to ensure that authorized users ar e adequately trained to use Stonegate Bank
Direct Connect requested by the Customer. The Bank shall not be responsible for errors made by th e Customer
in the use of the Online Banking system. Bank will update account inform ation each Banking Day. Bank will
exercise due diligence in entering such information; provided, however, that Bank will not be liable for any
losses, damages or expenses incurred by Customer as a result of unavailable, inaccurate, incomplete or outdated
information. Customer acknowledges that the i nformation provided through Stonegate Bank Direct Connect is
for purposes of ready reference only.
Initial Customer ID and PIN will be sent via: (choose one option below)
 E-mail
 Fax
By signing below, the undersigned agree s to all the terms and conditions listed on
pages 1 and 2 of this document.
STONEGATE BANK
By: Authorized Signer’s Name and Title
By: Authorized Signer’s Name and Title
Signature
Signature
Date
Date
Bank Use Only:
Account Officer: _________________________
Direct Connect ID: _______________________
Direct Connect PIN: ______________________
Cash Management ID: ____________________
Cash Management PIN: ______________
Wire PIN: ______________________________
10/08 Stonegate Bank Direct Connect Enrollment/Maintenance Form
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