Miscellaneous Forms

If you are unable to visit one of our locations, please print and complete the form you need and mail or fax back to us at:

Kentucky Farmers Bank
Attn: Operations
6313 US Route 60
Ashland, Ky 41102
Fax: 606-929-5199

IMPORTANT NOTICE: You must download and save the blank application before entering any information and then print or mail the completed form from your computer. Do not save a completed form from the web browser.

Change of Address To change your address or phone #. We will need separate forms for EACH account holder.
Stop Payment Request To stop single or recurring ACH Payments and checks. Please note this service will debit a $25.00 fee to your account.
Confirmation of Revoked Authorization Written confirmation that the debiting company has been notified of the payment cancelation AFTER applying the initial Stop Payment.
Written Statement of Unauthorized Debit Attest that an electronic, ACH, payment was unauthorized.
Cardholder Statement of Dispute                  Fraud - Dispute a debit card transaction as fraudulent. Please cancel your card if you have incurred any unauthorized charges.
Non-Fraud - Dispute an authorized charge to your account due to reasons of cancelation, returns, processing error, etc.          
e-Document Release To authorize a Signer or other non-account holder to receive account statements via eDocument access.
International Wire Transfer Request - Outgoing To send money from your Kentucky Farmers Bank account to a deposit account at another financial institution outside of the United States.
Domestic Wire Transfer Request - Outgoing To send money from your Kentucky Farmers Bank account to a deposit account at another financial institution within the United States.
Affidavit of Forgery To dispute a check that has a forged endorsement, forged drawer's signature, or an alteration made after the drawer's final possession.
Consumer Authorization for Direct Payment via ACH To transfer funds from another financial institution to a loan at Kentucky Farmers Bank.
Consumer Authorization for Direct Deposit via ACH To transfer funds from a Kentucky Farmers Bank deposit account to a deposit account or a loan at another financial institution.