First National Bank of the Lakes
                                     Cash Card Application


Name:                                                                                                   

Name:                                                                                                   

Address:                                                                                               

                                                                            Zip                                                                        

Checking Account #:                                                

Number of Cards:                                          

* $3 per card issued.

* $1 ATM transaction fee at non INSTANT CASH machine


* Funds from any deposit (cash/check) made at automatic teller machine
(ATM), will not not be available until the fifth business day of your deposit


Signature:                                                                                         

Signature:                                                                                         

Date: