OOLOGAH l 6695 E. 400 Rd. l 918.443.2474 • CHELSEA l 516 Walnut l 918.789.2581
Make the Switch to
Lakeside State Bank
We know how busy you are, so we have made it very convenient for
you to switch your accounts to LAKESIDE STATE BANK. Follow the four
easy steps in this switch kit and it will allow us to become “your” bank.
www.lakesidebankok.com
Making the Switch
1
Open A New Account at Lakeside State Bank
2
Redirect Your Direct Payments & Direct Deposits
3
Balance Your Old Account
4
Close Your Old Account
Open your account at any branch location. Complete our easy application to get
started today.
Use our Deposit and Payment Checklist and our Automatic Deposit/Withdrawal Form
to redirect your automatic transactions to your new Lakeside State Bank Checking Account.
Enroll in online banking and download our free mobile app.
Use our Account Balance Worksheet to settle your old account. Once that account is
balanced stop using your old account. Allow sufficient time for outstanding transactions
to clear.
Fill out the Account Closure Request Form to instruct your old bank to close your account.
The bank will send a check for any remaining balance per your provided request. Bring
your old checks to us and we will shred them for you.
THANK YOU FOR CHOOSING US!
**PLEASE COMPLETE THE FOLLOWING INFORMATION FOR A PERSONAL CHECKING ACCOUNT**
_________ SINGLE OWNER
_________ JOINT OWNER
**PLEASE CHOOSE THE TYPE OF DESIRED ACCOUNT**
________ CHECKING
SAVINGS
________ BUSINESS
MINOR/UTMA
***************PLEASE PRINT YOUR PERSONAL INFORMATION***************
PRIMARY ACCOUNT HOLDER INFORMATION (IF JOINT OWNERSHIP, PLEASE COMPLETE PAGE 2)
FIRST NAME & MIDDLE INITIAL
LAST NAME
SOCIAL SECURITY #
DATE OF BIRTH
(DO NOT PROVIDE IF FAXING OR EMAILING)
PHYSICAL ADDRESS
MAILING ADDRESS (IF DIFFERENT)
HOME PHONE #
WORK PHONE #
CELL PHONE #
ALT. PHONE #
DRIVER'S LICENSE #
STATE OF RESIDENCE
EMPLOYED
UNEMPLOYED
OCCUPATION*:
*IF YOU MARKED EMPLOYED OR RETIRED PLEASE STATE WHO YOU'RE
EMPLOYED WITH OR WHAT YOU'RE RETIRED FROM
RETIRED*
SECURITY QUESTIONS:
CITY BORN IN:
MOTHER'S MAIDEN NAME
EMAIL ADDRESS*
*By providing your email address, you are giving us permission to send email messages to you.
SIGNATURE
DATE
**DOCUMENTARY VERIFICATION (MUST PROVIDE TWO (2), ONE OF WHICH MUST BE A PRIMARY I.D.**
PRIMARY
SECONDARY
STATE DRIVER'S LICENSE OR ID CARD
CONCEAL CARRY ID
MILITARY I.D. CARD
PASSPORT
U.S. ALIEN REGISTRATION CARD
TRIBAL ID CARD
SOCIAL SECURITY CARD
STUDENT I.D. CARD
INSURANCE CARD
BIRTH CERTIFICATE
UTILITY BILL
ALONG WITH THE ABOVE MENTIONED DOCUMENTS PLEASE PROVIDE PROOF OF ADDRESS
HOW DID YOU HEAR ABOUT US?
DISABLED
SECONDARY ACCOUNT HOLDER INFORMATION
FIRST NAME & MIDDLE INITIAL
LAST NAME
SOCIAL SECURITY #
DATE OF BIRTH
(DO NOT PROVIDE IF FAXING OR EMAILING)
PHYSICAL ADDRESS
MAILING ADDRESS (IF DIFFERENT)
HOME PHONE #
WORK PHONE #
CELL PHONE #
ALT. PHONE #
DRIVER'S LICENSE #
STATE OF RESIDENCE
EMPLOYED
UNEMPLOYED
OCCUPATION*:
*IF YOU MARKED EMPLOYED OR RETIRED PLEASE STATE WHO YOU'RE
EMPLOYED WITH OR WHAT YOU'RE RETIRED FROM
RETIRED*
SECURITY QUESTIONS:
CITY BORN IN:
MOTHER'S MAIDEN NAME
EMAIL ADDRESS*
*By providing your email address, you are giving us permission to send email messages to you.
SIGNATURE
DATE
**DOCUMENTARY VERIFICATION (MUST PROVIDE TWO (2), ONE OF WHICH MUST BE A PRIMARY I.D.**
PRIMARY
SECONDARY
STATE DRIVER'S LICENSE OR ID CARD
CONCEAL CARRY ID
MILITARY I.D. CARD
PASSPORT
U.S. ALIEN REGISTRATION CARD
TRIBAL ID CARD
SOCIAL SECURITY CARD
STUDENT I.D. CARD
INSURANCE CARD
BIRTH CERTIFICATE
UTILITY BILL
ALONG WITH THE ABOVE MENTIONED DOCUMENTS PLEASE PROVIDE PROOF OF ADDRESS
DISABLED
Deposit and Payment Checklist
To make the process easier we’ve provided the following checklist to make
sure all of your direct deposits and automatic payments get redirected to
your new Lakeside State Bank account.
www.lakesidebankok.com
DIRECT DEPOSITS
_____ Payroll Direct Deposits (Contact your HR Department)
_____ Government Deposits (Social Security call 800-772-1213 or visit www.ssa.gov)
_____ Brokerage Deposits
_____ Transfers from Other Bank Accounts
_____ Child Support
_____ Other Court Issued Deposits
_____ Other Deposits
AUTOMATIC PAYMENTS
_____Gas
_____ Insurance (auto, home, health)
_____Electric
_____ Loans (cards, credit cards)
_____ Local/Long Distance Telephone Service
_____Mortgages
_____ Phone Services (cell and/or home)
_____ Transfers to Other Accounts
_____Water
_____ Child Support or Court Ordered Payments
_____ Cable/Internet Service
_____Other
ONLINE/MOBILE BANKING
_____ Switch your bill payees to your Lakeside Bank Account
_____ Once bill payments are set up in your new account, cancel them from your old account
2. Direct Deposit/Withdrawal Form
Complete this form for each company or organization with whom you
have arranged for automatic payment. Once completed, mail the form(s)
directly to the company or organization.
To
Company _____________________________________________
www.lakesidebankok.com
Address ______________________________________________
City, State, Zip _______________________________________
I (Name) ______________________________________________________________________________
have closed my checking account with (Current Bank) _______________________________________
effective ____________________.
I hereby authorize my automatic withdrawal in the amount of $__________________________ to be
changed from my current checking account #__________________________________ at _________
________________________________ to my new Lakeside State Bank account as listed below.
Checking Account # ___________________________________________
ABA Routing #103102070
Effective Date ________________________________________________
Amount to be withdrawn $ ____________________________________
Date of withdrawal _____________________________________________
Address __________________________________________________________________
City___________________
FOR DIRECT DEPOSIT YOU WILL
ONLY NEED YOUR ACCOUNT #
AND THE ROUTING #
State___________________
Zip___________________
If you have any questions or concerns please contact me at
______________________________________________________________________________________
Thank you for your attention in this matter.
_______________________________________
_______________________________________
Customer Signature
Joint Account Holder’s Signature
_______________________________________
_______________________________________
DateDate
ATTACH NEW LAKESIDE STATE BANK VOIDED CHECK
3. Account Balance Worksheet
Now that you are a Lakeside State Bank customer stop using your old account.
Begin with the checking account balance shown on your most recent bank
statement. Be as accurate as possible when completing this form.
www.lakesidebankok.com
1) Enter your current balance on your account statement. $_________________
2) List the amounts of deposits made on your last statement.
DATEAMOUNT
_______________________________________ _______________________________________
_______________________________________ _______________________________________
_______________________________________ _______________________________________
Enter the total of the deposits:
3) Subtotal by adding steps 1 and 2.
$_________________
$_________________
4) List all outstanding debits.
All checks, transfers, withdrawals that do not appear on your statement. Include any debit card purchases, ATM withdrawals, automatic debits and any other fees.
DATEAMOUNT
_______________________________________ _______________________________________
_______________________________________ _______________________________________
_______________________________________ _______________________________________
_______________________________________ _______________________________________
_______________________________________ _______________________________________
_______________________________________ _______________________________________
Enter the total of the debits:
$_________________
5) Subtract Step 4 from Step 3.
This amount should match your checkbook register balance.
$_________________
Note: All pending transactions must be cleared before the account is closed.
4. Account Closure Request
Complete this form to request that your current bank account be closed.
Once completed, mail the form(s) directly to your current bank.
Bank Name: ______________________________________________
www.lakesidebankok.com
I hereby request that the following account(s) with you be closed
Account Number ____________________________________________________
Checking ____Savings____Other___________________
Account Number ____________________________________________________
Checking ____Savings____Other___________________
Account Number ____________________________________________________
Checking ____Savings____Other___________________
Account Number ____________________________________________________
Checking ____Savings____Other___________________
Please prepare a cashier’s check for the balance of my account(s) payable to
Name ____________________________________________________________________
Address __________________________________________________________________
City___________________
State___________________
Zip___________________
If you have any questions or concerns please contact me at
____________________________________________________________
Thank you for your attention to this matter.
_______________________________________
_______________________________________
Customer Signature
Joint Account Holder Signature
_______________________________________
_______________________________________
DateDate