CLOSE YOUR CURRENT CHECKING ACCOUNT
PLEASE CLOSE MY ACCOUNTS
Once you have opened your new Bank Independent checking account, please send this form
to your previous fi nancial institution in order to close that checking account.
*Be sure that all checks have cleared, automatic payments and direct deposits have transferred.
Name Last First Middle
Street Address City State Zip
Work Phone Home Phone Social Security Number
Member FDIC | 877-865-5050 | bibank.com
ACH the balance of my checking
account to my new Bank
Independent Bank account
Mail me a check for the balance
outstanding to the address
indicated above.
New Account Number
Previous Financial Institution
Signature
Account Number to be Closed
Date
062205791
Bank Independent - Routing Number
OR
I am in the process of transferring my account(s) to Bank Independent. Please
consider this an offi cial notice to close my account(s) with you. I understand
that I will need to make sure that all my checks and automatic debits have
cleared before completely closing my account(s). I have already made ar-
rangements to switch my direct deposit and automatic debits. Please let me
know if you need anything from me before closing my ccount(s) or if I need to
fi ll out additional forms specifi c to your fi nancial institution.