Contact Us
Please provide the information below. All information is required unless indicated.
Contact Information
Title
Mr.
Ms.
Mrs.
Miss
Dr.
First Name
MI
Last Name
Suffix
Address1
optional
Address2
optional
City
optional
State
---Select---
AA (Military: The Americas)
AB (Alberta)
AE (Military:Europe)
AK (Alaska)
AL (Alabama)
AP (Military: Pacific)
AR (Arkansas)
AS (American Samoa)
AZ (Arizona)
BC (British Columbia)
CA (California)
CO (Colorado)
CT (Connecticut)
DC (D.C.)
DE (Delaware)
FL (Florida)
FM (F.S. of Micronesia)
GA (Georgia)
GU (Guam)
HI (Hawaii)
IA (Iowa)
ID (Idaho)
IL (Illinois)
IN (Indiana)
KS (Kansas)
KY (Kentucky)
LA (Louisiana)
MA (Massachusetts)
MB (Manitoba)
MD (Maryland)
ME (Maine)
MH (Marshall Islands)
MI (Michigan)
MN (Minnesota)
MO (Missouri)
MP (Northern Mariana Isl.)
MS (Mississippi)
MT (Montana)
NB (New Brunswick)
NC (North Carolina)
ND (North Dakota)
NE (Nebraska)
NH (New Hampshire)
NJ (New Jersey)
NL (Newfndland & Lab.)
NM (New Mexico)
NS (Nova Scotia)
NU (Nunavut)
NV (Nevada)
NW (Northwest Terr.)
NY (New York)
OH (Ohio)
OK (Oklahoma)
ON (Ontario)
OR (Oregon)
PA (Pennsylvania)
PE (Prince Edward Isl.)
PR (Puerto Rico)
PW (Palau)
QU (Quebec)
RI (Rhode Island)
SC (South Carolina)
SD (South Dakota)
SK (Saskatchewan)
TN (Tennessee)
TX (Texas)
UT (Utah)
VA (Virginia)
VI (Virgin Isl.)
VT (Vermont)
WA (Washington)
WI (Wisconsin)
WV (West Virginia)
WY (Wyoming)
YU (Yukon)
optional
Zip Code
optional
Contact Phone
NNN-NNN-NNNN
Email Address
Account Information
Are you currently a customer of Independent Bank?
Yes
No
Please provide us with your account number so that we can better assist you.
Account
Type
Checking
Savings
CD
IRA
Loan
Account Number:
optional
Message
Subject
Comments