eStatements Signup - First Mid Bank & Trust

This form is for business eStatements only. To sign up for personal eStatements, you must first have an Online Banking account, then sign up within Online Banking.

Please complete the following form to sign-up for business eStatements and to receive your required disclosure information online. You must already have a business checking account at First Mid Bank & Trust in order to sign up. Listing multiple accounts may result in a combined statement. If you have questions, please email us at DigitalSolutions@firstmid.freshdesk.com or contact a representative at the nearest First Mid Bank & Trust location.

Business Name*
Name*
First Last
Email*
Enter Email Confirm Email
Phone #*
Type of Accounts*
What type of business accounts would you like to sign up for eStatements? (Check all that apply.)
- Checking
- Savings
- Loans
Checking
Checking Account Number (1)*

Last Four Digits
Checking Account Number (2)

Last Four Digits
Checking Account Number (3)

Last Four Digits
Checking Account Number (4)

Last Four Digits
Savings
Savings Account Number (1)*

Last Four Digits
Savings Account Number (2)

Last Four Digits
Savings Account Number (3)

Last Four Digits
Savings Account Number (4)

Last Four Digits
Loans
Loan Account Number (1)*

Last Four Digits
Loan Account Number (2)

Last Four Digits
Loan Account Number (3)

Last Four Digits
Loan Account Number(4)

Last Four Digits
Acknowledgement
Terms of Use

1. Acceptance of terms of use and amendments

Each Please read our eStatement Agreement * The following provisions constitute an amendment to the deposit agreement of First Mid Bank & Trust (BANK) concerning electronic delivery of statements and notices, maintained by any individual, corporation, partnership, association, or other legal entity (YOU/YOUR).
ELECTION AND AUTHORIZATION FOR ELECTRONIC DELIVERY
If you sign up for eStatements, you will no longer receive a paper copy by mail and any notices associated with the account will also be sent electronically. If there is more than one owner/authorized signer that is party to the account, notices and statements to any one owner/authorized signer will be effective for all.
PROMPT REVIEW OF eSTATEMENTS
YOU must promptly review YOUR eStatement and any accompanying items and notify BANK (within the applicable time periods as specified in YOUR deposit agreement) of any error, unauthorized signature, lack of signature, alteration, or any other irregularity. Any applicable time periods within which YOU must notify BANK of any errors on YOUR account statement(s) shall begin on the date the BANK makes available to YOU the statement(s) and accompanying item(s) online. Further, YOU agree to notify BANK immediately if YOU are unable to access any of the information that has been delivered by the BANK to YOU in electronic format.
CONSENT
YOUR enrollment electronically on the First Mid online banking system confirms YOUR ability to access information in the electronic form.
TERMINATION OF AGREEMENT
In order for YOU to withdraw YOUR consent and terminate this agreement for eStatements, disclosures, etc. that YOU must notify the BANK in writing, and give us 30-day notice. YOU understand that YOU may request a paper copy of any statement, notice or disclosure by contacting BANK. In some cases, research fees may apply, see the BANK current fee schedules for details.
eStatement Acknowledgment *
Enter YOUR full name below to electronically sign the eStatement agreement.
Terms*
- I Agree to the Terms
By checking this box, I have read and understand the E-Statement Agreement
Date*
MM slash DD slash YYYY
Signature*

Please type your name in the box to act as your signature.
Email
This field is for validation purposes and should be left unchanged.

Checking

Savings

Loans

Acknowledgement

Terms of Use

1. Acceptance of terms of use and amendments

ELECTION AND AUTHORIZATION FOR ELECTRONIC DELIVERY

PROMPT REVIEW OF eSTATEMENTS

CONSENT

TERMINATION OF AGREEMENT

eStatement Acknowledgment *