* Please complete the highlighted fields below and then click "Print & Submit" *

What You Need to Know About Overdrafts and Overdraft Fees An overdraft occurs when you do not have enough money in your account to cover a transaction, but we pay it anyway. We can cover your overdrafts in two different ways:   1. We have standard overdraft practices that come with your account.   2. We also offer overdraft protection plans, such as a link to a savings account or to a personal line of credit, which may be less expensive than our standard overdraft practices. To learn more, ask us about these plans.   This notice explains our standard overdraft practices. What are the standard overdraft practices that come with my account?   We do authorize and pay overdrafts for the following types of transactions: Checks or other transactions made using your checking account number Automatic bill payments We do not authorize and pay overdrafts for the following types of transactions unless you ask us to (see below): ATM transactions Everyday debit card transactions We pay overdrafts at our discretion, which means we do not guarantee that we will always authorize and pay any type of transaction. If we do not authorize and pay an overdraft, your transaction will be declined.   What fees will I be charged if FSNB pays my overdraft? Under our standard overdraft practices: We will charge you a fee of $20.00 each time we pay an overdraft. There is a limit on the total fees we will charge you for overdrawing your account. You will be charged no more than 7 fees, or $140.00, per day.  What if I want FSNB to authorize and pay overdrafts on my ATM and everyday debit card transactions? If you also want us to authorize and pay overdrafts on ATM and everyday debit card transactions, call 1-800-749-4583, fax to 580-354-3402, visit www.fsnb.com, or complete the form below and present it at a branch or mail it to: FSNB, Attn: ODP, P.O. Box 33009, Fort Sill, OK, 73503 I do not want FSNB to authorize and pay overdrafts on my ATM and everyday debit card transactions. I want FSNB to authorize and pay overdrafts on my ATM and everyday debit card transactions. I understand that I may revoke my decision to authorize and pay overdrafts on my ATM and everyday debit card transactions in the same manner listed above for authorizing. First Name: (*required) Last Name: (*required) Last 4 numbers of social security number: (*required) All accounts for which I am an owner Specific Account Number(s) (*List checking accounts below) Account 1: Account 2: Account 3: Account 4: Account 5: Important: Please print for your records prior to submitting your request