Revocation of Overdrafts and Overdraft Fees

* - Indicates a required field

I confirm that I have selected to REVOKE my prior opt-in consent for ATM and everyday debit card transaction overdrafts. I understand that by doing so, my ATM and/or everyday debit card transactions will be declined if I do not have sufficient funds in my account. *

I understand that I may revoke my decision to authorize and pay overdrafts on my ATM and everyday debit card transactions in the same manner listed above for authorizing.


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Please print out this form for your records or print and mail to your local C&N branch office.
You may also mail this form to our ODP department:
Citizens & Northern Bank
Attn. ODP
90-92 Main Street
Wellsboro, PA 16901


Click the button at left to confirm that you have REVOKED your consent to opt-in to overdraft protection for your Citizens & Northern Bank ATM and everyday debit card transactions. *


If you would like to submit this form online, please click on the submit form button below.