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 this means for 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 mailing address is different than street address.
Mailing address is different than street address:
If payable on death, enter beneficiary information.
A Mediapolis Savings Bank representative will be contacting you about your selection above to complete the account opening process.
The purpose of this questionnaire is to begin the application process. All applications are subject to approval.
By submitting this application, I certify that I/we provided the information required and that I am at least 18 years of age and live in the US. I agree that I may receive electronic communications delivered to the e-mail address I provided.