Enrollment Form
If you are a current Farmers and Merchants depositor and would wish to enable your accounts to be viewed online, please fill out the necessary information below, print out this form, sign and mail the form to:

Farmers and Merchants Bank
111 West Clayton St
PO Box 278
Baldwyn MS 38824
 
First Name:
Last Name:
Address:
City:
State:  Zip: Phone:
E-Mail:
Social Security Number:
Primary Checking Acct. #:
 
Internet Banking
Bill Payment
Access account balances, transfer money, and conduct common banking tasks online Pay bills on-line. Pay any individual or company. $4.95 for up to 25 bill pays per month - first 60 days are free!
 
Account Number and Access Type*: Account Description, as you identify this account:  
1)
 
2)
 
3)
 
4)
 
5)
 
6)
 
7)
 
8)
 
Your signature in this form would be compared to our record prior to activating your account(s) online.
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Signature
Date