Personal Account Forms

Every form you need, all in a central location.

ATM/VISA Check Card Claim Forms

Cardholder Dispute Form (pdf 44kb)

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 35kb)

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 35kb)

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 82kb)

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.


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).


Using the e-mail form or sending e-mail is not secure. Please do not send any sensitive or private information (e.g., Social Security numbers, account numbers, account information, User IDs, Passwords, Personal Image or Name, etc.) using the form or via any general e-mail messaging system. If you want to send such information, please do so ONLY through Apple Bank's Online Banking service, which has a secure, encrypted Message Center with Secure Socket Layer. After logging in to Online Banking, please click on the Account Services tab or the Messages button to send a secure message.