Address Change Request

Customer Information

Full Legal Name*:
Social Security or EIN # *:
Effective Date*:
Telephone*:

Physical Address Information

Old Physical Address:*
City, State Zip:*	,
New Physical Address:
City, State Zip:	,

Old Mailing Address:

Same as Old Physical Address?*
Address*:
City, State Zip*:	,

New Mailing Address:

Same as New Physical Address?*
Address*:
City, State Zip*:	,
NOTE: For address change exceptions please see or call an Uwharrie Bank Account Executive

Please select below the accounts/products the new address needs to be changed on:

Uwharrie Bank (Checking, Savings, CDs, Loans)
eBanking (Debit Card, Bill Pay)
Mortgage (Serviced Mortgage Loan)
Credit Card (MasterCard)
Investor Relations (UCC common stock shareholder or Banks' preferred stock shareholder)
Strategic Alliance (Strategic Investment Advisors, Strategic Investment Group, BOS Agency, TSAC)

* indicates a required field

I certify under penalty of perjury that the foregoing is true and correct. I understand that by entering in my Username and Password used to access Uwharrie Bank's Online Banking is my electronic signature used to authenticate my request for any of the selected services. By clicking the Submit button below, I agree to abide by all terms, conditions, and disclosures pertaining to the services requested.