Get Online Fidelity Billpay Form

The Fidelity BillPay service is free of charge for all customers. To apply for the Fidelity BillPay service complete sign and return this form to the address below. Or apply for the service online at Fidelity. com. This service is solely for personal family or household purposes and not for any business or commercial purposes. Or apply for the service online at Fidelity. com. This service is solely for personal family or household purposes and not for any business or commercial purposes. If you have any questions please call us anytime at 800. 544. 5703. SERVICE AGREEMENT All account owners must sign below. I/We hereby understand that Fidelity Brokerage Services LLC is the provider of the Fidelity BillPay service. FIDELITY BILLPAY APPLICATION CUSTOMER INFORMATION Owner s Name First Name Middle Name Last Name Date of birth mm/dd/yyyy Account number Joint Owner s name if any Social Security number Owner Joint Owner Owner s phone numbers Evening Daytime Ext. E-mail address Fidelity BillPay enables you to pay bills electronically through the Internet or eligible mobile devices as determined by Fidelity. The service is available to brokerage accounts with individual joint estate or trust registrations. The Fidelity Account has a 2 500 minimum balance requirement to activate the BillPay service. If applicable you will have 60 days to meet the requirement. The Fidelity BillPay service is free of charge for all customers. To apply for the Fidelity BillPay service complete sign and return this form to the address below. Or apply for the service online at Fidelity. com* This service is solely for personal family or household purposes and not for any business or commercial purposes. If you have any questions please call us anytime at 800. 544. 5703. SERVICE AGREEMENT All account owners must sign below. I/We hereby understand that Fidelity Brokerage Services LLC is the provider of the Fidelity BillPay service. By signing below I/we hereby understand that and/or agree to 1 authorize Fidelity Brokerage Services LLC to post bill payment transactions originating from the Fidelity BillPay service to my/our Fidelity Account 2 this Fidelity BillPay Application is subject to review and acceptance by the provider of the service 3 the Fidelity BillPay service is subject to the Fidelity BillPay Service Agreement which is incorporated into this application by reference and made a part hereof as such terms are currently in effect and as they may be amended in the future 4 I/we will be sent the Fidelity BillPay our agreement to the Fidelity BillPay Service Agreement 5 I/we may terminate the Fidelity BillPay service at any time by calling customer service or sending a written termination request using the phone number and address provided in the Fidelity BillPay Service Agreement the Fidelity BillPay Service Agreement is also available at Fidelity. com or by calling 800. 544. 5703 and 6 I/we hereby authorize the provider of the service to honor any instructions entered through the Internet using my/our customer identification number and personal identification number.