Information About Procedures for Opening a New Account:
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 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.
* Indicates Required Information
CHECK ONE OR MORE OF THE ACCOUNTS BELOW TO
CHECK ONE OR MORE OF THE SERVICES BELOW TO APPLY FOR:
I certify that I am at least 18 years of age and I have accurately and
fully completed all items on this application. Under penalties of perjury,
I certify that:
Or check all that apply:
I have been notified that I am subject to backup withholding.
I am not a U.S. citizen or resident (complete W-8) form.
The IRS does not require your consent to any provision of this document
other than the certifications required to avoid backup withholding.
Please note, this application is subject to verification and approval.
In order for us to process your application correctly, we may need
to contact you to verify some of the information or request additional
documentation. When you submit this application, you
certify that everything stated above is true and accurate. When you
submit this application, you also agree that this Institution reserves
the right to review your credit history through an authorized bureau.
If you have any questions, please contact us at 701-782-6295,
or by e-mail at email@example.com.
By clicking below, I hereby certify that everything I have stated
above is correct. You may keep this application whether or not it is
approved. By clicking below, I authorize you to check my credit and
employment history and verify other information which I have provided