To change the information regarding your Online Account please complete the form below. Please print and sign the modification form. Then click submit.

Please bring in or mail the signed form to the following address:

SmartBank
P.O. Box 1910
Pigeon Forge, TN 37868

For assistance in moving your checking account from another financial institution to SmartBank, please see our Helpful Forms link under "Personal Services." Contact an FSR for additional information at 865.453.2650.

CUSTOMER INFORMATION

Your Name
Address
Address 2
City
State
Zip
Phone	- -
Email Address
SSN#
Primary Checking Acct. #

REQUESTED CHANGES

	Add An Account Add an account to Online Banking.		Add Bill Payment Pay bills on-line. Pay any individual or company. This service is FREE with all SmartBank Checking Accounts.
	Cancel Online Banking Cancel my Online banking service.		Cancel Bill Payment Please cancel my Online Bill Payment service.

ACCOUNT INFORMATION

	Acct. #	Access Type	Account Description
1
2
3
4
5

* Definitions for Access Types:

Full Access - You will have the full access available on this account.
View & Deposit - You may view account information and transfer funds into this account.
View Only - You will be able to view balances and transactions.
Add Bill Pay - You will be able to pay bills from this account using online bill pay.
Remove From Bill Pay - You will no longer be able to pay bills with this account using Online Bill Pay.
Remove Account - You will no longer be able to access this account Online.

Please Note: You must be an owner on each of these accounts.

By signing this modification form I am requesting that the above actions be taken concerning my Online Banking account.

__________________________________	______________
Signature	Date

If you are unable to print this document, please visit us at our nearest branch to assist you in the process, or contact us at 865.453.2650.