Overdraft Privilege Request

Privacy Preference Election

You have the option to restrict the sharing of personal and financial information with our affiliates (companies we own) and non-affiliates (outside companies) that we do business with.

To limit your sharing, please fill out and submit your information below.

Please correct the following problems, and try again:
  • First name is required
  • Last name is required
  • Last 4 digits of SSN required
  • Last 4 digits of primary account is required

1: Identify Yourself

For joint accounts, this election will apply to all holders listed on the account(s) and all accounts owned. If you own multiple accounts, you only need to choose one account.

Primary Authorized Account Signer:
Joint Authorized Account Signer:

2. Select Your Privacy Preferences:


Why do we share this information?

AND/OR


Why do we share this information?

AND/OR


Why do we share this information?

3. Submit Your Request

YES. I want First State Bank to limit my Privacy Preferences as detailed above.

If at any time, you wish to change your privacy elections, please call 866-372-1275.