Step Three
Authorization to Close Account
If you have any questions,
we will gladly talk you through it.
1.877.Bangor1
This serves as authorization to close the account(s) detailed below and
transfer the balance and all accrued interest to Bangor Savings Bank.
FORMER BANK INFORMATION
FORMER BANK
ADDRESS
CITY STATE ZIP
ACCOUNT HOLDER INFORMATION
CUSTOMER NAME
SOCIAL SECURITY NUMBER
Account Number: __________________________________________________
❒
Checking
❒
Savings
❒
Money Market
Account Number: __________________________________________________
❒
Checking
❒
Savings
❒
Money Market
Account Number: __________________________________________________
❒
Checking
❒
Savings
❒
Money Market
BANGOR SAVINGS BANK ACCOUNT INFORMATION
Bangor Savings Bank Routing Number: 211274382
Bank Account Number: ___________________________________________________________
AUTHORIZATION
Account Holder Signature:_________________________________________________________ Date:__________________
Account Holder Signature:_________________________________________________________ Date:__________________
Please acknowledge your receipt of this notice by sending confirmation of this change to:
NAME ADDRESS
Please immediately close and transfer the balances of the following account(s):
Please notify account holder immediately if this form is not sufficient to close the account.
Please transfer balances by check payable to: Account Holder, c/o Bangor Savings Bank. Reference the new account number below
on the check’s memo line. Check should be mailed to Bangor Savings Bank, PO Box 930, Bangor, Maine 04402-0930 or
a local branch:
__________________________________________________________________________________________________________________
Member FDIC Equal Housing Lender
© Bangor Savings Bank 2006
