Personal Account Application

Required Field

New Customer
Existing Customer

Individual Information

Individual

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Mother's Maiden Name ID Type/Number State Issued Date of Expiration Street Address City State Zip Code Mailing address is different than street address. Mailing Address City State Zip Code Home Phone Number Work Phone Number Cell Phone Number Fax Number E-mail Address Please do NOT email me important news and updates. Employer Name

 Add Co-Applicant (To add additional individuals)

Please Select the Accounts you would like to open

Checking Accounts

Community Points Checking

Savings Accounts

Regular Savings
Christmas Club
Vacation Club
Certificate of Deposit
Individual Retirement Account

Interest Bearing Checking Accounts

Reward Checking
Now Account
Money Market Account

Customer Information Policy and Privacy Policy

To help the government fight the funding of terrorism & money laundering activities, federal law requires all financial institution to obtain, verify, and record information that identifies each person who opens the account. What this means for you: When you open an account we will ask for your name, address, DOB, and other information that will allow us to identify you, such as your drivers license or other identifying documents. Privacy - UCB does note disclose any non-public personal information about you to anyone, except as permitted by law.

Applicants Signature

By completing the above, I am providing information for the purpose of obtaining an account and I authorize United Community Bank to obtain information concerning any of the statements I have made. I also authorize United Community Bank to make inquiries they feel are necessary to determine my credit worthiness including, but not limited to obtaining credit reports from credit reporting agencies and other credit information from other sources.

I understand that this application is subject to United Community Banks approval. Once submitted and upon approval, you will be contacted to sign documents for the new account. You may also deliver the completed application in person to any United Community Bank Branch. You may also mail the completed application to attention Retail Operations, P.O. Box 248, Raceland LA 70394-0248

Applicant's Signature Co-Applicant's Signature