Request for Address Change

Account number: __________________________

Name: ___________________________________

Old Address ______________________________

City __________________ State _______________ Zip ____________



New address: _____________________________

City __________________ State _______________ Zip ____________



Customer Signature: ____________________________

Print Name: ___________________________________

Date: ____________________



Send to:

First National Bank of America
Customer Service
P.O. Box 980
East Lansing, MI 48226