American Trust Bank Personal Online Banking Enrollment
To enroll for American Trust Internet Banking services, please complete this enrollment form online, print, sign, and return to us via:

fax@678)338-2270
Online Banking Department
880 Holcomb Bridge Road Building C
Roswell, Georgia 30076
or in person at any of our locations
On joint accounts, each signer must submit a separate application.
Customer Information
l
Please type or print
*Full Name
*Address
*Address
*City
 *State *Zip
*Daytime phone
Evening phone
Mobile phone
*email address
*Date of Birth
Drivers License Number
*Social Security Number
*Account Number
* indicates a required field
  
Requested Services
Account Access - Free
Access account balances, transfer money and conduct common banking tasks online.		 Bill Payment - $6.95 per month
If you choose to use our bill pay service, you may set up your vendors and pay bills online.

For security and identification purposes please complete the following:

*City of Birth
*County of Birth
*Mother's Maiden Name

Signature:_________________________________________ Date:______________
By signing or submitting this form, I acknowledge that I have read and agree to the terms and conditions and I authorize American Trust Bank to issue a temporary password on my behalf, which I must change to a private password of my choosing the first time I log in to American Trust Bank Online Banking.