E-Statement Enrollment & Maintenance Form

Please complete all necessary information below to enroll in E-Statements.

Are you currently enrolled in online banking?

First Name:
Last Name:
Social Security Number:
Phone Number:
Street Address:
City, State & Zip:
Email Address:

List below all checking and/or savings accounts for which you are an owner and would like to receive an E-Statement. Please note if you receive a combined statement, you only need to sign up for the leading account.

Account Number *
Account Type *
I have more than 1 (one) account with Peoples Bank. Please set me up with a "Combined Statement" so that I can receive all my statements with one User ID.

You should know that you are responsible for the care and safekeeping of your account number(s) and password(s). It is recommended that you periodically change your password(s) as a security measure. Allowing another, unauthorized person access to this information will allow them to view confidential information regarding your account(s). You are responsible for notifying us if your email address is changed. In the event an E-Statement is returned undeliverable, due to a faulty email address, your statement will be mailed to the postal address currently on file.

By signing up for E-Statements, I understand I will no longer receive a paper statement sent to me by US Postal mail.

In order to confirm you are able to view PDF files, please click here to view the sample E-Statement and enter the code word located on the sample and your name below.

Code Word
  Signature (First and Last Name)