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Inquiry Form


HORIZON ONLINE HOMEBANKING INQUIRY


IMPORTANT: You must be a current customer of First National Bank and Colorado First National Bank to enroll in Horizon Online.

Our branches are located in Goodland, Oberlin and St. Francis, Kansas. Bennett and Kirk, Colorado

Name
Name:
Address:
City: State: Zip:
Phone:
SSN:
Email:
Accounts to Be Accessed through Horizon Online
You may submit a second request for additional accounts.
Account # Online Reference Name
1.
2.
3.
4.
5.
6.
IF NO TRANSFER OPTIONS ARE CHECKED BELOW, ACCOUNTS WILL BE VIEW ONLY. YOU MAY REQUEST THE TRANSFER FUNCTION AT A LATER DATE BY CONTACTING CUSTOMER SERVICE.

I'd like to be able to transfer funds FROM: I'd like to be able to transfer funds TO:
the following accounts: (check all that apply)
all listed checking/money market accounts
all listed savings accounts
all listed line of credit accounts
all listed overdraft protection accounts

the following accounts: (check all that apply)
all listed checking/money market accounts
all listed savings accounts
all listed First National Bank CD accounts
all listed loan or line of credit accounts
all listed overdraft protection accounts

Disclosures
Government regulations require that we make the following disclosures available to you when you apply for an account. By clicking on documents listed below, you may view and print the disclosures for your records. You must click your browser's back button to return to this application.

Terms and Conditions of your Account
Current Rates
Funds Availability Policy
Electronic Funds Transfer Act

ATM User Precautions
Online Access Agreement
Truth In Savings

Submitting this Application

By selecting the submit button, you certify the following:

1. You have read and printed all available disclosures.

2. Everything stated on this application is true and correct to the best of your knowledge.

3. You have read and understand this application.

4. This application will be retained by First National Bank and Colorado First National Bank whether or not it is approved.

5. First National Bank and Colorado First National Bank is authorized to obtain credit reports, income and employment history, to secure follow-up credit reports or income and employment verification and to answer questions about your credit experience at First National Bank and Colorado First National Bank.

6. You are at least 18 years old and a U.S. resident.

7. I agree that this account is subject to all applicable Federal laws and regulations and the laws of my state if First National Bank and Colorado First National Bank has a branch located in my state. Otherwise, the agreement is governed by the State of Kansas .

8. If I choose to submit this application electronically. I acknowledge that, regardless of whether I use a web browser with security features, First National Bank and Colorado First National Bank is unable to ensure that data will not be intercepted by third parties. I agree that First National Bank and Colorado First National Bank will not be liable should such interception occur. First National Bank and Colorado First National Bank strongly suggests that you use a browser with 128-bit encryption.

9. DO NOT SUBMIT MORE THAN ONE APPLICATION FOR EACH PRODUCT.


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