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LIBERTY NATIONAL BANK DEBIT CARD APPLICATION FORM
Debit Card   Business Card   HSA Card
Your Information
Business Name (if applicable):
First Name:
Middle Initial:
Last Name:
Date of Birth: / /    (Please enter your DOB in MM/DD/YYYY format.)
Last four digits of your Social Security Number:
Phone Number:
Work Phone Number:
Address:


City:
State:
Zip Code:
eMail Address:
Confirm eMail Address:
Account Information
Liberty National Bank account(s) :
Last 4 digits of Account Number:   
Checking
Savings
Last 4 digits of Account Number:   
Checking
Savings
Last 4 digits of Account Number:   
Checking
Savings
Last 4 digits of Account Number:   
Checking
Savings
 
Overdraft Services Consent Form
What You Need to Know about Overdrafts and Overdraft Fees

An overdraft occurs when you do not have enough money in your account to cover a transaction, but we pay it anyway. We can cover your overdrafts in different ways:
  • We have standard overdraft practices that come with your account.
  • We also offer overdraft protection plans, such as a link to a Bounce Protection plan, a Savings account or a line of credit, which may be less expensive than our standard overdraft practices. To learn more, ask us about these plans.
This notice explains our standard overdraft practices.

WHAT ARE THE STANDARD OVERDRAFT PRACTICES THAT COME WITH MY ACCOUNT?
We do authorize and pay overdrafts for the following types of transactions:
  • Checks and other transactions made using your checking account number
  • Automatic bill payments
We do not authorize and pay overdrafts for the following types of transactions unless you ask us to (see below):
  • ATM transactions
  • Everyday debit card transactions
We pay overdrafts at our discretion, which means we do not guarantee that we will always authorize and pay any type of transaction.

If we do not authorize and pay an overdraft, your transaction will be declined.

WHAT FEES WILL I BE CHARGED IF LIBERTY NATIONAL BANK PAYS MY OVERDRAFT?
Under our standard overdraft practices:
  • We will charge you a fee of up to $35.00 each time we pay an overdraft.
  • There is a limit of $175.00 on the total fees we can charge you for overdrawing your account per day.
WHAT IF I WANT LIBERTY NATIONAL BANK TO AUTHORIZE AND PAY OVERDRAFTS ON MY ATM AND EVERYDAY DEBIT CARD TRANSACTIONS?
If you also want us to authorize and pay overdrafts on ATM and everyday debit card transactions, call (419)673-1217 or complete the form below.

If you prefer, you can download a copy to print, complete and present at any of our locations or mail to:
Liberty National Bank Attn: Account Services 100 East Franklin Street Kenton, OH 43326
  Overdraft Services Consent Form (.pdf)
I do not want Liberty National Bank to authorize and pay overdrafts on my ATM and everyday debit card transactions.

I want Liberty National Bank to authorize and pay overdrafts on my ATM and everyday debit card transactions.

Please note: You must choose one of the options above to submit the Master Money application.
 
Signature
Please download, read, and keep for reference this disclosure about the types of electronic fund transfers we can handle for consumers.
  Electronic Fund Transfers: Your Rights and Responsibilities (.pdf)

I have read the EFT: Rights and Responsibilities document.


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