Bank Voice Authorization Form
Use this form to authorize a bank representative to discuss or service an account by phone using the details provided below.
Customer and Account Identification
Account Holder Full Name
*
First Name
Middle Name
Last Name
Partial Account Identifier or Customer ID
*
Bank Name
*
Primary Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Authorization Details
Authorized Representative Full Name
*
First Name
Middle Name
Last Name
Relationship to Account Holder
*
Please Select
Spouse
Parent
Child
Sibling
Legal Guardian
Power of Attorney
Business Partner
Employee
Other
Permitted Voice Authorization Scope
*
Balance Inquiry
Transaction Discussion
Address Update
General Account Servicing
Verification and Contact
Best callback number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred contact method
*
Please Select
Phone call
Text message
Email
Other
Verification note or instructions
Submit Form
Should be Empty: