Checking or Savings Account Application

Required Field

General

How did you hear about us?

You will need the following items:

Driver's license or State ID
Previous home address (if you have lived at your home address less than 2 years)
U.S. Social Security number
U.S. checking or savings account to fund the account

Account Type

Are you applying for an individual or joint account?

Individual
Joint

Which branch do you/would you bank with most often?

Bluffton
Findlay-Tiffin Avenue
Findlay-Trenton Avenue
Lima-Eastown Road
Lima-Bellefontaine Road
Ottawa
Pandora

Primary Account Holder

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Mother's Maiden Name Valid Drivers License or State ID Number State Issued Date of Expiration Street Address City State Zip Code

How long have you lived there?

Years Months Mailing address is different than street address. Mailing Address City State Zip Code Previous Address City State Zip Code Home Phone Number Cell Phone Number E-mail Address Passport Number Passport Expiration Date Please do NOT email me important news and updates. Occupation Employer Name

Joint Account Holder

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Mother's Maiden Name Driver's License 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 Previous Address City State Zip Code Home Phone Number Cell Phone Number E-mail Address Please do NOT email me important news and updates. Passport Number Passport Expiration Date Occupation Employer Name

Ownership

Ownership type

Single Owner (individual)
Joint (with right to survivorship)
Joint (with no right to survivorship)

Do you want this account Payable on Death?

This is recommended so ensure your funds can be easily given to a person(s) of your choosing in the event of your passing.

If payable on death, enter beneficiary information.

First Name Middle Initial Last Name Suffix Social Security Number Street Address City State Zip Code Relationship to holder Date of Birth Mother's Maiden Name Phone Number

Opening Deposit

Please choose how you would like to make your opening deposit:

Minimum Opening Deposit by Account Type:

First Choice Rewards, First Choice Basic and First Choice Easy Banking Checking	$50
Hi-Fi Money Market Account	$50
Simply Savings, Student Savings	$25
Moola Moola Kids Club	$5
First Choice Rewards Savings	$1

For existing customers, we can transfer your opening account deposit from another FNB account. Transfer my opening deposit of $ from account number to my new account.
I understand that by checking this box I am authorizing First National Bank to transfer the above amount from the above account at the time my new account is opened, by the end of the next business day after the application is received and/ or processed.
I authorize First National Bank to make a one-time ACH withdrawal of $ from my account at with routing number and account number . The one-time withdrawal will be made by the end of the next business day after the application is received and/or processed.
Once my account is open I will complete an external transfer from another financial institution to my First National Bank account. I understand the opening deposit must be made within 30 days of account opening or risk the account being closed.
I will drop off my opening deposit to a local First National Bank branch. I understand the opening deposit must be made within 30 days of account opening or risk the account being closed.

Account Preferences

Please select the account preferences you would like:

MasterCard Debit Card
ATM Card
Checks. Please consider if you would like single or duplicate checks.
Overdraft Privilege, Protection, or Coverage. Please contact me to discuss the specific options available.
Online/Mobile Banking
Online Bill Payment

How would you like to sign your account documents?

I would like to come in and sign my Signature Card and make my deposit. We will contact you upon account approval to schedule a time that is convenient.
Signing Location
I would like my Welcome Kit to be mailed to me. I will complete and return my signature card. I understand that I may be asked to stop into the branch or provide additional information, if needed.

Endorsement

Please select all the statements that apply:

As a condition of acceptance of my deposit application, I authorize you to obtain a copy of my bank account history and subsequent reports for the purpose of opening a checking or savings account. I am not subject to backup withholding, because I am exempt from backup withholding, or because I have not been notified by the IRS that I am subject to backup withholding as a result of failure to report all interest or dividends, or because the IRS has notified me that I am no longer subject to backup withholding. I am subject to backup withholding. I am not a United States citizen or resident. You must be a US citizen to open an account online. Non-US citizens should contact your nearest branch location to open an account. I certify under penalties of perjury that the statements contained in this section are correct.

By submitting this application, I certify that I/we gave truthfully and fully provided the information required and that I am at least 18 years of age and live in the US. I certify that I have read and agreed to all the Terms & Conditions, Privacy Policy, Funds Availability, Truth in Savings, Electronic Funds Transfer, and Schedule of Fees. I agree that I may receive electronic communications posted on the First National Bank web site or delivered to the e-mail address I provide, including information required by various laws and regulations. I authorize First National Bank to access my credit bureau information, check my employment, and report to credit reporting agencies First National Bank's experience with me.

By submitting this application, I/We certify the accuracy of the above information and authorize First National Bank of Pandora (the "Financial Institution") to access our credit file(s) to authenticate our identity(s) and facilitate the processing of this application for this First National Bank of Pandora account only. I/We understand that we may be asked questions based on the information in our credit file(s) as part of this process. I/We also understand that the Financial Institution may review our credit history and past banking relationships before accepting this application. I certify that I /we gave truthfully and fully provided information required and that I am at least 18 years of age.

E-Sign Act Disclosure and Consent

Before proceeding you must confirm that you have read and agree to the terms of the Electronic Signature Act Disclosure available at the link below.

E-Sign Act Disclosure and Consent

I/we confirm that I have read and agree to the terms of the E-SIGN Act Disclosure above. I also agree that the Internet access device(s) I/we will use to receive the related legal disclosures, agreements, online account signature form and the instructions meet(s) the system requirements described in the disclosure presented above; and I/we consent to receiving the related legal disclosures, agreements, online account signature form and the instructions electronically. Primary Account Holder's Signature Date Joint Account Holder's Signature Date

Checking or Savings Accounts Application

Important Information About Procedures For Opening A New Account & The Patriot Act