E-mail address
First name Last name
Institution name
City State Zip code
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Number of checking accounts.
Number of checks returned, or NSF, including: electronic returns (debit card, ATM, DOS, etc.)
Number of overdrawn checks paid, or OD.
Number of transfers made into checking accounts from overdraft protection line of credit and/or from savings and other deposit accounts.
Per item $ fee for NSF. $