Login Information
Please select Login-ID between 8-30 characters. It may contain all letters or a combination of letters, numbers or special characters; it is case-sensitive and cannot contain spaces. Please select a Login-ID that you can remember as you will use this Login-ID once your account is activated.
Desired Login Name
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:
Customer Information
Please provide at least one email address and one phone number to receive your secure access code for your Online Banking login. You will be required to set your password after entering your secure access code.
First Name
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:
Middle Initial:
Last Name
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:
Business Name (if applicable):
Social Security #/TIN
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:
Address
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Address:
City
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:
State
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:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
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Home Phone
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Work Phone:
Mobile Phone:
Email Address
*
:
Account Number
Account Type
Account Number
Account Type
Please Select
Checking
Savings
Money Market
Loan
CD/IRA
Please Select
Checking
Savings
Money Market
Loan
CD/IRA
Please Select
Checking
Savings
Money Market
Loan
CD/IRA
Please Select
Checking
Savings
Money Market
Loan
CD/IRA
Please Select
Checking
Savings
Money Market
Loan
CD/IRA
Please Select
Checking
Savings
Money Market
Loan
CD/IRA
Please Select
Checking
Savings
Money Market
Loan
CD/IRA
Please Select
Checking
Savings
Money Market
Loan
CD/IRA
Please Select
Checking
Savings
Money Market
Loan
CD/IRA
Please Select
Checking
Savings
Money Market
Loan
CD/IRA
Please provide the 9 digit Account Number(s) that you wish to access through Internet Banking. All accounts must have the same ownership as the information provided in the Customer Information above.
Signature and Disclaimers
This document is being secured with SSL encryption provided by your browser. Your information will be encrypted when using this form while in transit between your browser and American Riviera Bank.
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Signature:
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Date:
(Type your full name)
(Today's Date)
Important Disclosure Regarding Deposit Insurance on Noninterest-bearing Transaction Accounts