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Account Revenue Solution Questionnaire
 
*Bank Name:
*Contact Name:
*Street Address:
*City:
*State:
*Zip:
*Email:
*Phone:
 
1.Number of offices where personal checking accounts are opened:
2.Number of personal checking accounts opened in a typical year:
3.Number of personal checking accounts closed in a typical year:
4.Total NSF income from personal checking accounts last year:
*5.Amount charged for an NSF:
*6.Total number of personal checking accounts:
7.Number of personal checking accounts that have debit card(s) and used it/them:
        a. zero times last month .........................................................
        b. 1-20 times last month ........................................................
        c. more than 20 times last month ........................................
8.Total number of debit card transactions last month:
9.Total number of signature transactions:
10.Current debit card daily limits:  
        ATM ............................................................................................
        POS ...........................................................................................
11.Total annual interchange income:
12.Average debit card purchase amount (e.g.$38.79):
13.Do you currently have a debit card rewards program?
If so, please briefly describe your program.  
Fields marked with an asterisk * are required.
 
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