Quick Switch Program

Complete this form for each company or organization with whom you have arranged for automatic payments. 
Call First National Bank at 979-865-3181 for additional forms, or make copies of this form.

Information relating to my current checking account at:

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Please print name of financial institution

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Date of draft payment

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Checking account number     (Please attach voided check)

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Name on account

I hereby authorize automatic payment from my checking account at First National Bank of Bellville, P. O. Box 128, Bellville, Texas  77418.

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Company to receive this form 

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Address of Company

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My/Our account number at this company

New ABA Routing Number:  113103687

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My checking account number

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My/Our signature(s)

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Daytime telephone number                                                     Date

(Please complete, sign and bring in to First National Bank)

If there are questions, or assistance is needed in completing the form, please call Brenda or Bertha at 1-800-235-5737
or e-mail to mailbox@fnbbellville.com.