New Account Application
First Name
Middle
Last
Date of Birth
Home Address (street)
City
State
Zip Code
E-mail Address
Mailing Address (if different)
City
State
Zip Code
E-mail Address
Telephone
Years at Present Address
Social Security No. or Federal ID
Drivers License No.
Previous Home Address (If less than one year)
Years There
Firm Name or Employer and Position
Telephone
Address (street)
City
State
Zip Code
Name and Address of Nearest Relative not living with you, that we may contact, who will know your whereabouts at all times.
Telephone
Co-Applicant
Date of Birth
Drivers License No.
Social Security No.
Home Address (street)
City
State
Zip Code
E-mail Address
First Employment
Position
How Long
Business Phone
Nearest Relative Not in Household
Relationship
Address
City
State
Please Select the Accounts you would like to open
Checking Accounts Savings Account
Community Checking Regular Savings
Regular Checking Christmas Club
Business Checking Vacation Club
Small Business Checking Certificate of Deposit
  Individual Retirement Account
Interest Bearing Checking Accounts  
Reward Checking  
Now Account  
Money Market Account  
Customer Information Policy
In accordance with Section 326 of the USA Patriot Act signed October 26, 2001, Community is required to obtain a copy of documents used in identifying our new account customers and in identifying signatory individuals added to existing or new accounts. In some cases, identification will be requested for those individuals banking with the bank prior to the effective date of the customer identification requirements because original documentation was not obtained with the opening of the account, or the bank is unable to form a reasonable belief that it knows the identity of the existing customer. In all cases protection of our customer’s identity and confidentiality is the Bank’s pledge to you.
Applicants Signature
By completing the above, I am providing information for the purpose of obtaining an account and I authorize Community Bank to obtain information concerning any of the statements I have made. I also authorize 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 Community Bank approval. Fax completed application to (985) 537-6414; upon approval, you will be contacted to sign documents for the new account. Or you can deliver the completed application in person to any Community Bank office.

Applicants Signature  
Co-Applicants Signature