Forms & Manuals Request for Check Card Waiver of Account Signing Authority (Consumer)

REQUEST FOR CHECK CARD WAIVER OF ACCOUNT SIGNING AUTHORITY (CONSUMER)

Client Name: Account Number:

The undersigned Client hereby requests that City National Bank (CNB) issue a CNB Check Card for the referenced account to the following person(s): 1 Nam ( ) - Date of ) e: Phone Number: Birth: Home Address: City, State, Zip: SSN or Primary ID # : Expiration Date*: Issue Date*: Issuing Entity*: Issuing Location*: 2 Nam ( ) - Date of ) e: Phone Number: Birth: Home Address: City, State, Zip: SSN or Primary ID # : Expiration Date*: Issue Date*: Issuing Entity:* Issuing Location*: (To add clients, press the keys. To delete clients, press keys.) *Required only if Primary ID # is used.

The undersigned has read and understands the terms and conditions for Electronic Fund Transfer services applicable to the Check Card as stated in the CNB Account Agreement and Disclosures and the Consumer Electronic Fund Transfer Agreement and Disclosure. The undersigned understands that the Check Card is a debit card, that transactions originated by means of the Check Card will be charged directly to the referenced account and that the Check Card may also be used to perform transactions at CNB and certain other automated teller machines. The undersigned acknowledges and agrees that transactions performed and charged to the account by means of the Check Card using either the personal identification number (PIN) associated with the Check Card or the signature of the assigned holder of the card are deemed authorized NOTWITHSTANDING THE SIGNING AUTHORITY IDENTIFIED IN THE DEPOSIT AGREEMENT.

The undersigned waives any and all signing restrictions associated with the referenced account for transactions originated by means of the Check Card and associated PIN or authorized signature.

This request and waiver shall remain in effect from the date hereof until the undersigned shall notify CNB to cancel a Check Card issued hereunder or shall notify CNB as stated in the Consumer Electronic Fund Transfer Agreement and Disclosure that a Check Card or PIN issued hereunder is lost or stolen.

Signed Print Name Date

Signed Print Name Date (To add signature line, press the keys. To delete signature line, press keys.)

ID 18063E (Rev 05/2016) (071)