Enrollment Form
Online Banking for Business through Quicken, QuickBooks, or Microsoft Money

Please print a hard copy of this form, fill it out, sign it and mail to:
Commerce Bank, Online Banking for Business, PO BOX 411635, Creve Coeur, MO 63141
Enroll me in Online Banking through Quicken, QuickBooks, or Money (Select one)
___ Online Account Access        ___ Online Account Access & Online Bill Pay        
___ Add Online Bill Pay to current Online Account Access
Software & Computer Information
Software Type: (Select only one) ___QuickBooks®/QuickBooks® Pro 2006   ___Quicken® 2006    ___Microsoft® Money 2006
Computer Type: ___ Windows ___ Macintosh
Company Information
Type of Business : ___ Sole Proprietorship ___ Limited Liability Company
  ___ Partnership ___ Limited Partnership
  ___ Corporation ___ Other (describe)_____________________

Company Name: _________________________________________________________________

Address: _________________________________________________________________

City: _________________________________ State: ________ Zip __________________

Business Phone: (_______)___________________

Federal Tax ID#: ___________________________
Do you have a Commerce account? ___ Yes ___No If "No", do you want us to call? ___ Yes ___No
Best time to call: ___ AM ___ PM Where: ___ Home ___ Work
Security Information
Name (of authorized signer): _____________________________
Date of Birth: _______/_______/_______ Social Security #: _______-______-_________
Mother's Maiden Name: ____________________
Commerce Account Information (I would like to access the following Commerce Bank accounts)
 Checking Account Number (Payment Account): __________________________
Other Account Number: __________________________
Account Type : ___ Checking ___ Savings* ___ Money Market*
*Online Bill Pay not available with these accounts
Authorization and Agreement
The undersigned applied for, and if approved, authorizes Commerce Bank to establish the requested Online Banking for Business service (Service) for the above-named business. The use of the Service is subject to the Online Banking for Business Terms and Conditions ("Terms and Conditions") provided with the fulfillment materials upon implementation. Subscribing to the Service, or permitting another to use the Service, constitutes acceptance of the Terms and Conditions. Commerce Bank is authorized to debit the designated Payment Account, or other Account as provided in the Terms and Conditions, for monthly service charges until the Service is canceled.

Customer Signature (authorized signer)__________________________________ Date ___________
E-mail address (optional) __________________________
Would you like to receive special offers and information on our bank products and services via email? ___ Yes ___ No

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