Insouth Bank

New Deposit Account Application

FDIC Deposit Insurance has temporarily increased from $100,000 to $250,000.

INSOUTH Bank is participating in the FDIC’s Transaction Account Guarantee Program. Under that program, through December 31, 2009, all no interest-bearing transaction accounts are fully guaranteed by the FDIC for the entire amount in the account. Coverage under the Transaction Account Guarantee Program is in addition to and separate from the coverage available under the FDIC’s general deposit insurance rules. Please ask your INSOUTH Bank officer or CSR to explain this expanded coverage.


USA PATRIOT Act customer notice

INSOUTH Bank is proud to support the USA PATRIOT Act. The purpose of this act is to help protect you, your family, and our country by preventing financing of terrorist. All financial institutions are required to verify the identity of anyone opening an account or adding a new financial product or service. When you open or add an account, we will ask for your name, street address, date of birth, and other information that will allow INSOUTH Bank to identify you.  You must list a street address on your application; however, you may designate a PO Box for mailing purposes if you prefer in the appropriate space below.  We may also ask to see your driver's license or other identifying documents. We appreciate your assistance and understanding.


If you have questions or need help to apply for membership please contact our Customer Service Department.


Hours of operation:
Monday - Friday 8:30 am - 5:00 pm, CST
Primary Use for the account
Where did you hear about INSOUTH Bank?
Consumer    Business

Personal Information

First Name: * Mailing Address (If Different)
Last Name: * Street Address: *
Middle Name: City: *
Street Address: * State: *
City: * Zip: * 
State: *    
Zip: *     
SSN: - -    
Driver License Number:    
Driver License State:    
Driver License Exp. Date:    
Birth Date    
Home Phone: * - -    
Work Phone: * - -    
E-mail Address *    
Mother's Maiden Name:    

Joint Account Holder (if applicable)

First Name: * Mailing Address (If Different)
Last Name: * Street Address: *
Middle Name: City: *
Street Address: * State: *
City: * Zip: * 
State: *    
Zip: *     
SSN: - -    
Driver License Number:    
Driver License State:    
Driver License Exp. Date:    
Birth Date    
Home Phone: * - -    
Work Phone: * - -    
E-mail Address *    
Mother's Maiden Name:    

Account Details

Accounts

Regular Checking Account
No Fee Checking Account
INPrime Checking
Relationship Banking
eAccount
Interest Checking Plus
Investor Account
Savings
Custom Savings
IRA
Certificate of Deposit

 

Contact our Customer Service Department for Current Rates

Ownership

Single-Party Account without Payable on Death Designation

Upon account holder's death, account ownership passes to the deceased account holder's estate under the will or by intestacy.

Single-Party Account with Payable on Death Designation

Upon account holder's death, account ownership passes to the assigned beneficiaries. The account is separate from the account holder's estate.

Multiple-Party Account with Right of Survivorship

All account holders have ownership of the account. INSOUTH Bank may pay any portion of the account to any one of the account holders. Upon an account holder's death, the account ownership passes to the remaining account holders.

Multiple-Party Account with Right of Survivorship and Payable on Death Designation

All account holders have ownership of the account. INSOUTH Bank may pay any portion of the account toMultiple-Party Account without Right of Survivorship All account holders have ownership of the account. INSOUTH Bank may pay any portion of the account to any one of the account holders. Upon an account holder's death, account ownership passes to the deceased account holder's estate under will or by intestacy. any one of the account holders. Upon an account holder's death, the account ownership passes to the remaining account holders. Upon the death of the final surviving account holder, account ownership passes to the assigned beneficiaries.

Multiple-Party Account with Right of Survivorship and Payable on Death Designation

All account holders have ownership of the account. INSOUTH Bank may pay any portion of the account to any one of the account holders. Upon an account holder's death, the account ownership passes to the remaining account holders. Upon the death of the final surviving account holder, account ownership passes to the assigned beneficiaries.

Convenience Account

The account holder permits a cosigner on the account. The cosigner does not own the account, however the cosigner may make transactions for the account holder. Upon an account holder's death, account ownership passes to the deceased account holder's estate under will or intestacy. Account ownership is not affected by any payments made to the cosigner. INSOUTH Bank may pay any portion of the account to the cosigner prior to receiving notice of the account holder's death.

Other

Joint Account

Additional Services

Bonus Check Card or Premium Check Card
Credit Card
Online Banking

P.O.D. Beneficiaries

Upon the death of the last account owner, ownership of the account shall be divided equally among the surviving beneficiaries listed below. The beneficiaries listed below are beneficiaries to all the accounts listed under the Accounts section.
Name of Beneficiary


Identifying Information


 

Certification & Backup Withholding

I certify under penalties of perjury that the Social Security Number/Tax ID Number shown above is my correct Taxpayer Identification Number and that I am NOT, unless designated below, subject to backup withholding either because:

  • I am exempt from backup withholding, or
  • I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of failure to report all interest or dividends, or
  • The IRS has notified me that I am no longer subject to backup withholding. I further certify that unless designated below, I am a U.S. person (including a U.S. resident alien).
I am not subject to backup withholding
I am subject to backup withholding
I am not a United States citizen or resident (Complete Form W-8BEN)

Authorization

By agreeing below, I / WE certify that information provided on this Account Card is accurate and complete. I / WE agree to the terms and conditions and acknowledge receipt of the documents which include the Membership and Account Agreement, the Truth-in-Savings Rate and Fee Schedule, the Funds Availability Policy disclosure, the Electronic Funds Transfer Agreement (EFTA) and any other documents provided to ME/US, and incorporated into the Membership Application packet provided by INSOUTH Bank. I / WE agree to be bound by any amendments done in the future to any INSOUTH Bank documents. If I / WE request any form of an EFT service and it is provided to ME/US, I / WE agree to the terms and conditions of the EFTA and acknowledge receipt of the EFTA.THE INTERNAL REVENUE SERVICE DOES NOT REQUIRE YOUR CONSENT TO ANY PROVISION OF THIS DOCUMENT OTHER THAN THE CERTIFICATIONS REQUIRED TO AVOID BACKUP WITHHOLDING.