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Forms

ATM/VISA Check Card Claim Forms

Cardholder Dispute Form (pdf 28kb)

Use this form to report a merchant dispute for purchases made with your Apple Bank ATM/Visa checkcard.  Visa does require that the account owner attempt to first resolve the dispute with the merchant.  If attempts at resolution are unsuccessful then the Bank will act on behalf of the customer.  Please keep an accurate record of the contact information as it is required as part of the form submission.

Report of Unauthorized ATM/Check Card Purchases (pdf 22kb)

Use this form to report fraudulent usage of your ATM/check card.  This form should only be used for signature related purchases.  Fraud is defined as theft of your card information.  If you have provided your account number to a merchant and were debited without authorization you must use the Cardholder Dispute form.

Report of Unauthorized ATM/Check Card Transfers (pdf 20kb)

Use this form to report fraudulent usage of your ATM/check card.  This form should only be used for transactions completed with your PIN.  This includes all unauthorized ATM withdrawals.

Pension Forms

IRA Beneficiary Designation Form (pdf 19kb)

Use this form to name a beneficiary or beneficiaries for your IRA, SEP or ROTH Retirement Account with the Bank.  To change beneficiaries, you simply complete a new form and submit it to the Bank.

IRA Distribution Form (pdf 16kb)

Use this form to withdraw funds from any Apple Bank traditional or Roth IRA plan.  Please keep in mind that there may be fees and taxes involved so be sure to check with your tax advisor.

Waiver of Required Minimum Distribution Form (pdf 18kb)

Use this form when you attain the age of 70 ½ or older and you are required to take mandatory distribution from your pension plan and you chose to take mandatory distribution from another financial institution.


Branch Forms

Blank Signature Card (pdf 21kb)

Use this signature card when you want to establish a new account with Apple Bank or when you need to make a change to an existing account title.  Please check with customer service before sending any changes to the Bank.

Apple Bank Switch Kit for Checking and Savings Accounts

Account Switch Kit (pdf 80kb) Use this Switch Kit to quickly and easily transfer your checking and savings account(s) from other institutions to Apple Bank. The Switch Kit includes convenient forms for you to change payroll and benefit direct deposit, change automatic payments and close your old account(s).
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