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Account Owner or Custodian First Name
Beneficiary First Name
Apply this deposit:
Towards the purchase of a NEW CD or Savings Account. Note, if a Savings Account already exists, the deposit will be applied to the existing
Towards an EXISTING CD or Savings Account.
Fixed Rate CD
CollegeSure Honors Savings Account
529 Account Number (only if for existing account)
Additional contributions ($25 minimum) may be made to existing CDs under the same terms and conditions as the original CD. Additionally, the maturity date of any additional contributions will match the maturity date of the existing CD.
Deposit Option (Mimimum - E-Check: $25; Direct Deposit $25)
Direct Deposit - ACH Plan
Direct withdrawal from your personal checking or savings account.
Financial Institution Name
ABA Routing Number
(Customer verification qualified by accessing our secure Online Banking portal. Please initial and date.)
By completing below, I certify this deposit is for the intended qualified higher education expenses of the Beneficiary. If this is a rollover, I understand my contribution will be treated as earnings until the Plan receives appropriate documentation from me.
Depositor’s Full Name
© 2017 College Savings Bank, a Division of NexBank SSB. All rights reserved.
NexBank, SSB and its affiliates do not provide tax, legal or accounting advice. This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. You should consult your own tax, legal and accounting advisors before engaging in any transaction.