Personal Checking Account Application

Important Information About Procedures For Opening a New Account:

(PATRIOT ACT)
To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.

What does this mean to you? - When you open an account, we will ask you for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents. If you are a new customer and have not opened an account with us in the past, you will be required to come into the bank and sign the Signature Card in order to complete this new account. We would prefer existing customers to come into the bank to sign your Signature Card, but will make other arrangements if you are unable to do that.

Please choose the type of account you are applying for:

Primary Account Holder Information

Prefix Street Address
First Name and Middle Initial Mailing Address
Last Name City
Social Security Number State
Driver’s License Number Zip Code
State Issued Email Address
Date of Issuance Home Phone Number
Date of Expiration Work Phone Number
Date of Birth Cell Phone Number
Employer    

Additional Account Holder Information

Check here if this is a joint application (co-owner)  
Check here if the additional account holder is a signer only  
    Mailing address if different from above
Prefix Street Address
First Name and Middle Initial Mailing Address
Last Name City
Social Security Number State
Driver’s License Number Zip Code
State Issued Email Address
Date of Issuance Home Phone Number
Date of Expiration Work Phone Number
Date of Birth Cell Phone Number
Employer    

Please check all that apply:

Would you like Payable on Death (POD) set up for the account?
Would you like us to place a Check Order for you?
Would you like to apply for a Personal Reserve Account (PRA)? - overdraft protection (please fill out separate application online)
Would you like to apply for a Visa Check/Debit Card? (please fill out separate application online)
Would you like to apply for EZ Online Banking? (please fill out separate application online)
Would you like us to help you move your Social Security or any other Direct Deposit to this account?
Would you like us to help you move some automatic payments to this account?

Comments or Additional Information

Thank you for applying online. We will start the paperwork to open this account and will contact you to set up a time that is convenient for you to sign your Signature Card and make your initial deposit (minimum $100 to open). If you are unable to come into the bank and already have an account with us, we will make other arrangements with you.

Authorization

By clicking on the "I Accept" box below, the applicant(s) request(s) the described services and agrees to the terms and conditions governing the services, including any fees and charges. The applicant(s) agree(s) that all information is accurate and authorizes the financial institution to verify credit and employment history, if necessary, by any means, including preparation of a credit report by a credit agency. Check the "I Accept" box to indicate that you (the applicant) have read the agreement and accept its terms.

I Accept

Important Disclosure for Personal Account Applications

I agree that I have read and agree to the following product Disclosures, Agreements, and Terms & Conditions:

I Agree Electronic Disclosure