Personal Deposit Application

Simply complete the form below and we’ll start processing your application right away. If you have questions, please contact us during regular business hours at (319) 668-2525.

*Indicates Required Field

New Account Information

Please choose which type of account you would like to open
Type of Account *
Initial Deposit Amount $ *
Account Ownership *
Individual Joint**
Source of Deposit *

Primary Account Holder Information **Joint Account Holder Information (if applicable )
First Name *
First Name
Middle Initial *
Middle Initial
Last Name *
Last Name
Social Security # *
- -
Social Security Number
- -
Drivers License Number *
Drivers License Number
State *
Date of Issuance *
/ /
Date of Issuance
/ /
Date of Expiration *
/ /
Date of Expiration
/ /
Day Phone *
() -
Day Phone
() -
Evening Phone *
() -
Evening Phone
() -
Date of Birth *
/ /
Date of Birth
/ /
Mothers Maiden Name *
Mothers Maiden Name


Additonal Product Offerings

Please check all products you are interested in and we will contact you with additional information.
ATM/Debit Cards Certificate of Deposit
Direct Deposit Loan Products
Online Express Internet Banking e-Statements
Bill Pay Express (online bill payment) Mobile Express Banking
By clicking submit, I certify that the above information is correct and that I have read and agree to abide by the account requirements and have reviewed and agree to the Terms and Conditions and Truth in Savings disclosures via electronic means. (Please print a copy of the disclosures to obtain for your records.) I also understand that Farmers Trust & Savings Bank, in accordance with the USA PATRIOT act, will use the above information as part of our Customer Identification Program to obtain verifications of identity and backgrounds before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your full credit report, before opening any account. By submitting this form I/we grant full permission to do so.
Please use the box below for questions or comments