CAPITAL EXPRESS INTERNET BANKING FOR BUSINESS -CLIENT AUTHORIZATION

General Company Information – Completed by Customer

Company Name:______

Address:______

City, State, Zip:______

Contact Name:______/ Contact Telephone Number: ()-
Tax ID Number:______

E Mail Address: ______

Fax Number: () -Cell Number of Main Contact: ()-

COMPLETED BY BANK ONLY

Company Portfolio Number______

BANK USE ONLY

BRANCH INTAKE & AUTHORIZATION
CSR
Name / Br. Officer
Authorization: / Date
Authorized:
All Funds Transfer Forms Must be Received prior to Online Banking Set-Up / ACH Origination Application
ACH Origination Agreement
ACH Risk Assessment / Wire Transfer Agreement
OPERATIONS:
Date Established
on System: / Established
By:
Client Set up Super Admin Set Up File Transfer(s) Set up Fund Transfer(s) Set up
ACH Set Up:
Forms Received:
ACH Origination Application
ACH Origination Agreement
ACH Risk Assessment / Wire Transfer Set Up:
Forms Received:
Wire Transfer Agreement
Notes:

CAPITAL EXPRESS INTERNET BANKING FOR BUSINESS

CLIENT ACCOUNT AUTHORIZATION

Completed by customer

The following information is required for every account accessed by your company through the system. Photocopy and fill out this worksheet as needed.

  1. Account Nickname:

Account Type: Checking/Int ChckMoney MarketLoanSavingsCD

Account Number:

Fund Transfer Options

Domestic Wire Out Foreign Wire Out Internal Transfers Bill Pay

Loan Payments ACHOrigination

  1. Account Nickname:

Account Type: Checking/Int ChckMoney MarketLoanSavingsCD

Account Number:

Fund Transfer Options

Domestic Wire Out Foreign Wire Out Internal Transfers Bill Pay

Loan Payments ACHOrigination

  1. Account Nickname:

Account Type: Checking/Int ChckMoney MarketLoanSavingsCD

Account Number:

Fund Transfer Options

Domestic Wire Out Foreign Wire Out Internal Transfers Bill Pay

Loan Payments ACHOrigination

I HAVE READ AND AGREE TO ABIDE BY THE CAPITAL EXPRESS ONLINE BANKING POLICY AND AGREEMENT.

______

Authorized SignaturePrinted Name

___/___/___

TitleDate

CAPITAL EXPRESS INTERNET BANKING FOR BUSINESS -ADMINISTRATIVE EMPLOYEE AUTHORIZATION

The Super Administrator is a high level person in the business who will have the ability to assign access to the business’s accounts by the business’s employees.

Super Administrator Name:______/ Contact Phone: ()-
E Mail Address: / Fax Number: ()- / Cell Number: ()-

Authorized Access Times

Access DayBegin TimeEnd TimeAccess DayBegin TimeEnd Time

Monday:am/pm:am/pmFriday:am/pm :am/pm

Tuesday:am/pm:am/pmSaturday :am/pm :am/pm

Wednesday:am/pm:am/pm Sunday:am/pm :am/pm

Thursday:am/pm:am/pm

Note: If authorized access time is not specified, the access time will be granted from 6:00am to 11:59pm only.

Administration Options

Inquire EmployeeAdd Internal Transfer Template

Delete EmployeeChange Internal Transfer Template

Assign Account Access to EmployeesDelete Internal Transfer Template

Add Wire Transfer Template

Add ACH Transfer TemplateChange Wire Transfer Template

Change ACH Transfer TemplateDelete Wire Transfer Template

Authorized Fund Transfers:

Internal Transfers International Wire Out

Domestic WireOut Access to Bill Pay

ACH Origination

______

Authorized Signature Printed Name

___/___/___

TitleDate

CAPITAL EXPRESS INTERNET BANKING FOR BUSINESS - COMPANY AUTHORIZED EMPLOYEES

Capital Bank enables employees within the Company and the level(s) of access the Authorized Signer wishes to grant. The Authorized Signer of the Company shall notify Capital Bank of any changes to who the permitted users are to access Company accounts via Capital Express.

LIST OF USERS:

USER #1:
E Mail Address (Required):
Contact Phone: ()- / USER #2:
E Mail Address (Required):
Contact Phone: ()-

Super Administrator Super Administrator

Administrator Administrator

Supervisor Supervisor

Employee Only Employee Only

View Account Activity Only View Account Activity Only

Internal Transfer Internal Transfer

Domestic Wire Out Domestic Wire Out

International Wire Out International Wire Out

ACH OriginationACH Origination

Access to Bill Pay Access to Bill Pay

NOTES/ LIST ACCOUNTS:

USER #3:
E Mail Address (Required):
Contact Phone: ()- / USER #4:
E Mail Address (Required):
Contact Phone: ()-

Super Administrator Super Administrator

Administrator Administrator

Supervisor Supervisor

Employee Only Employee Only

View Account Activity Only View Account Activity Only

Internal Transfer Internal Transfer

Domestic Wire Out Domestic Wire Out

International Wire Out International Wire Out

ACH Origination ACH Origination

Access to Bill Pay Access to Bill Pay

NOTES/LIST ACCOUNTS:

______

Authorized SignaturePrinted Name

Title: Date: ___/___/___

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October 1, 2015