To enroll for Millennium Bank Business On-Line Banking please print this form, choose from the list of services below, complete your information and fax to 847-296-9501.
During banking hours we will process this enrollment form and send you an e-mail letting you know when you are able to log into our system.
Included in this e-mail will be your user name and temporary password.
If you have any questions, please contact a Personal Banker at 847-296-9500.
On-Line Banking only ______ On-Line Banking with Bill Pay ______
Business Name: ______________________________________________________________________
Signer(s) Name: ______________________________________________________________________
Signer(s) Name: ______________________________________________________________________
Signer(s) Name: ______________________________________________________________________
Address: ____________________________________________________________________________
City: _______________________________________________ State: __________ Zip: ________
Contact Phone Number(s): ______________________________________________________________
FEIN Number: __ __ - __ __ __ __ __ __ __
E-Mail Address: _______________________________________________________________________
Checking Account Number: ________________________ Certificate of Deposit: _________________
Savings Account Number: ____________________ Loan Account: ___________________________
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Signature of Authorized Signer(s) Date
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Signature of Authorized Signer(s) Date
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Signature of Authorized Signer(s) Date