Security Code Request Form

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Important Information About Your Security Code
Your security code means that no one else can obtain information on your
accounts. But you have to do your part, too.
Never tell anyone your security code. Do not give your code to anyone
•
including family members or friends.
If you need to write it down, keep it in a private place. Do not identify it as
•
the security code.
The security code should not be the same as your PIN for your ATM/Debit
•
Card.
How to Create Your Security Code
1. You may call the Bank to speak with a Customer Service
Representative who can help you establish your security code.
2. You can fill out the security code request portion of this form and
place it in the mail or deliver it to the bank.
Your code should be at least four digits/letters and can be a combination of
•
letters and numbers.
Your code should be something that you will easily remember. You will need
•
it every time you get information on your accounts.
However, it also should not be something that others can easily guess.
•
It should not be your birthdate, social security number, telephone number,
•
your street address, etc. as these were involved in a breach.
Because they are used frequently, you should not use consecutive numbers
•
such as 1234 or repetitive numbers such as 1111. They may be easy for you
to remember, but they are also easy for others to guess.
Security Code Request Form
Name_____________________________________________________________
Street
Address___________________________________________________________
City, State, Zip_____________________________________________________
Phone
Number___________________________________________________________
Security Code
Selected___________________________________________________________
Signature__________________________________________________________

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