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Change of Address Form

To ensure the security of your personal information, Royal Bank requires an original signed form to change your address. Simply print, complete and drop off the Change of Address Form at your local Royal Bank office or mail it to us at:

Royal Bank
Attn: Customer Service
P.O. Box 10
Elroy, WI 53929

Customer Information

First Name: Middle Name:

Last Name:

Effective Date of Address Change:

Current Address

Street:
City:		State:
Zip Code:		Telephone Number:

New Address

Street:
City:		State:
Zip Code:		Telephone Number:

Contact Information

Daytime Number:
Evening Number:
E-mail Address:

I request the above changes be made to my customer information file.

Signature:_____________________________________Date___________

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