Customer Information Change Form - The Little Bank
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1Customer Information Change Form
Customer Information Form Instructions:
Required Fields are marked in red. For all other fields, only information that has changed
must be completed.
Name:*
Address:
City:
State, Zip:
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Employer:
Special Instructions or Notes to the Bank:
Customer Signature:
Submission Instructions:
To submit your completed form to the Bank for processing, either:
(1) Bring this form to your local branch,
(2) Fax the completed form to 252-317-2837, OR
(3) Mail the completed form to the little bank, Inc., Attention Deposit Operations, 1011 Red
Banks Road, Greenville, NC 27858
*Name change would require additional proof: marriage, divorce etc.
For Branch Use Only:
ID/Authorization Verified**: __________________________
Date: _______________
Change Made:
__________________________
Date: _______________
**Verify customer signature and authorization on account with the signature card on file.
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Parent category: Business