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Mobile Deposit Enrollment Form

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  I wish to enroll in Mobile Deposit
Please complete the enrollment information below. *Asterisk indicates required field.
First Name*
MI: 
Last Name*
NetTeller ID/Alias*
Account(s) to be linked*:
List below the personal checking and/or savings account number(s) you would like linked to your Mobile Deposit service. Account(s) selected must also be linked to your NetTeller online banking account.
Email*

(Email used with NetTeller Account)
Confirm Email*
Phone*  
Important Information: You will receive an email with your enrollment status by the end of the next business day. Qualified enrollments will find the "Deposit" icon added to your mobile banking app menu.

For additional information, contact us at mobiledeposit@civistabank.com or 1-888-383-5133.