2017 Basic Banking for Massachusetts Certification Question Title * 1. Were you a participating Basic Banking for Massachusetts financial institution in 2016? Yes No Question Title * 2. Please type the name of your financial institution as you would like it to appear on our website: (Required.) Question Title * 3. I certify that my financial institution has BOTH a qualified Basic Banking for Massachusetts Checking Account and a Basic Banking for Massachusetts Savings Account. This means the accounts meet all of the following criteria.Basic Banking Checking Account Guidelines:- Requires no more than $25.00 to open the account- Charges a monthly fee of no more than $3.00- Provides at least 15 free withdrawals, including at least eight (8) checks, per month- Charges no more than $1.00 for each withdrawal over the allowable number of free withdrawalsBasic Banking Savings Account Guidelines:- Requires no more than $10.00 to open an account- Charges no monthly fee on account balances of $10.00 or more- Charges a monthly fee for no more than $1.00- Pay interest on all account balance of $10.00 or more (Required.) Yes No Question Title * 4. I certify that my financial institution has a qualified Basic Banking for Massachusetts Checking Account ONLY. This means the account meets all of the following criteria.Basic Banking Checking Account Guidelines:- Requires no more than $25.00 to open the account- Charges a monthly fee of no more than $3.00- Provides at least 15 free withdrawals, including at least eight (8) checks, per month- Charges no more than $1.00 for each withdrawal over the allowable number of free withdrawals Yes No Question Title * 5. I certify that my financial institution has a qualified Basic Banking for Massachusetts Savings Account ONLY. This means the account meets all of the following criteria.Basic Banking Savings Account Guidelines:- Requires no more than $10.00 to open an account- Charges no monthly fee on account balances of $10.00 or more- Charges a monthly fee for no more than $1.00- Pay interest on all account balance of $10.00 or more Yes No Question Title * 6. Our financial institution does NOT have any qualified Basic Banking for Massachusetts accounts at this time. True Question Title * 7. Please indicate the name and contact information for the person to whom we should address Basic Banking correspondence. (Required.) Name: Title: Email: Phone Number Question Title * 8. Please provide the name and contact information for an additional contact, if applicable. Name: Title: Email: Phone Number: Thank you so very much for participating in this *green* alternative to a paper mailing! Done