Account Information Change Request • Heritage BankHeritage Bank

Account Change Type*

Add Account Holder
Add Beneficiary
Request To Close Account

Personal Information

Your Name*

First Last

Email Address*

Account Number*

Add Account Holder

Add Beneficiary

Request To Close Account

Name*

First Middle Last

Social Security Number*

Date of Birth*

Picture ID Type*

Picture ID Number*

Picture ID State*

State

ID Expiration Date*

Home Phone*

Work Phone

Cell Phone

Email*

Enter Email Confirm Email

Address*

Street Address Address Line 2 City State ZIP Code

Occupation*

Other Occupation

Non-Interest Bearing Checking Accounts - Simply write a check to bring your account to a zero balance and your account will be closed. You do not need to submit this form.

Certificate of Deposit - Original CD must be presented to the bank in order to cancel a CD. Please do not submit this form.

Heritage Direct Savings Account - Please submit this form and Heritage Bank will transfer your account balance plus accrued interest into your linked checking account. This transfer may take up to three days to post to your account. If you’re closing your account within the first 90 days of opening there will be a $25 closing fee.

All Other Deposit Accounts - Please choose from the following options for how you would like to receive the account balance plus accrued interest and submit this form. If you’re closing your account within the first 90 days of opening there will be a $25 closing fee.

Heritage Bank will transfer account balance to your linked checking account (Heritage Direct only)
Heritage Bank will transfer account balance to another Heritage Bank account
Mail me a check (not available for Heritage Direct accounts)

Account Number*

Reason for Closing Account*

Please provide a copy of the new account holder's unexpired ID to any of our Heritage Bank locations.

If you would like to add an additional account holder please submit another request.

We will be in contact with you once we have processed your request.

If you would like to add an additional beneficiary, please submit another request.

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