Basic Banking for Massachusetts

2010 Sign-Up Form

Print bank name exactly as it should appear on the list of participating banks

Check all items to confirm that your bank’s accounts meet the Basic Banking for Massachusetts guidelines.

Basic Checking Account

The account requires a deposit requirement of no more than $25.00 to open the account

(Note: If account is free, check “yes”)

(Note: If account is free, check “yes”)

Basic Savings Account

(Note: If account is free, check”yes”)

(Note:  If account is free, check “yes”)

Note: Basic Banking accounts cannot be conditional, e.g. limited to those who open both a checking and savings account, to those with Direct Deposit and/or to those meeting income or other eligibility requirements.

Review

I have reviewed the guidelines for Basic Banking for Massachusetts and have indicated above that our bank’s accounts meet the stated guidelines.

Future Communications

Future communications should be sent to (if different from name above):