Bank of Yazoo
PERSONAL Online Banking Enrollment Form

Instructions

  1. Fill out the PERSONAL Enrollment Form online. All fields are required.
  2. Click the Print Enrollment Form Button at bottom of page.
  3. Sign the printed form and Fax to 662-751-8853 or drop the signed form off at one of our branch locations.
  4. Within 3 days you should receive an email with sign-on instructions.

Customer Information

First Name: Middle Initial: Last Name:
Address:  
City:   Zip Code:
Home Phone: Cell Phone: Work Phone:
Email Address:  

Account Access Information

Please provide the Account Number, Account Type and Access Level for each account that you wish to access using Online Banking. All accounts must have the same ownership as the information provided in Customer Information above.

Account Number Account Type Access Level Access Level Description

Full Access: View account(s) and make all online transactions

View & Deposit: View account(s) and make online deposits, NO withdrawals.

View Only: View account(s), NO online transactions.

Deposit Only: Make online deposits, NO viewing or withdrawals.