Online Banking e-Statements Enrollment Form

Home Online Forms Online Banking e-Statements Request Form
  • e-Statement Request Form

  • e-Statement Request

  • Reason for contacting us today
  • Personal Information

  • Account Information:

  • Account #1
    Account #2
    Account #3
    Account #4
  • eStatement Enrollment Terms and Conditions
  • Please remember that you must be enrolled in our Online Banking to take advantage of e-Statements.


You may also print this application and mail it or stop by one of our locations.

Please Note: By submitting this form you are certifying under penalties of perjury that you are the above named person with in this document, that you are an owner on the account(s) listed above and that the email address listed above is your email address.

Enrollment for the electronic statement service requires you to have access to a personal computer, which permits you to access the email account listed above. By completing and clicking on the Submit button below, you are authorizing Farmers Savings Bank to email you that your statement is ready for you to view on-line. By choosing this, you will not receive paper copies of those statements. If you currently receive your check images back with your statements, you will continue to receive check images with your e-statement. All regulations and consumer protection acts applying to paper statements will also apply to statements received via electronic means. After you enroll, you can always terminate your enrollment and stop receiving your statement electronically by notifying Farmers Savings Bank via this electronic form or by sending notification to the address listed below. There is no fee to cancel your enrollment and you will then begin receiving paper copies of your statements again. If you wish to receive a paper copy of any statement that has been sent to you electronically,  please contact the bank.
Fax and Mail Information:
Farmers Savings Bank, P.O. Box 251, 305 Doty Street, Mineral Point, WI 53565-0251
Bookkeeping Department Fax: (608)-987-2775
If you have any questions, please contact us at (888)-443-3226.