Personal Checking/Savings Account Application
Submitter Information (Required)
First Name (required)
Last Name (required)
Resolve the errors marked in red before submitting again.

Privacy Policy:
Our privacy policy protects the privacy of your personally-identifying information that you provide us online.

Please be aware that the First National Bank of Waterloo's regular service areas are in the following counties: in IL - Bond, Clinton, Effingham, Fayette, Madison, Marion, Monroe, Randolph, Shelby, St. Clair and Washington counties and in MO - St. Louis and St. Charles counties and St. Louis City.  If you are outside of our service area, we will contact you for further consideration as we decide whether we can provide you with account services at this time.

All new accounts are verified through ChexSystems before opening.
 

Important Information about Procedures for Opening a New Account
Identification Procedures Requirements: 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.

Security Notice:
You should ONLY fill out this Application online if you are using a browser with the latest security enhancements. If you don't have the latest version, download a copy now.

Instructions:
1. Complete Application and click "Submit Application" or print and drop it off at any banking center.
2. To safeguard your privacy, QUIT your browser and restart it again after using this form. This form is NOT saved in your computer's memory when you quit your browser.
3. We will contact you with the location of our closest office for you to sign a signature card. You may also be requested to provide photocopies of your Social Security card and Driver's License, or other documentation.

Primary Account Holder Information
First NameMiddle InitialLast Name
Address Information
Date of BirthSocial Security No.Inquiry Code
Driver's License No.Driver's License StateDriver's License Issue DateDriver's License Expiration Date
Home PhoneWork PhoneCell PhoneEmployerOccupation
Email Address
Joint Account Holder Information
First NameMiddle InitialLast Name
Address Information
Date of BirthSocial Security No.Inquiry Code
Driver's License No.Driver's License StateDriver's License Issue DateDriver's License Expiration Date
Home PhoneWork PhoneCell PhoneEmployerOccupation
Email Address
Account Titling Information
(required)
In Trust For
NameSocial Security No.
Custodial
NameSocial Security No.
Payable on Death
Beneficiary Name(s)
I/We would like to apply for the following account(s):
Checking Accounts
Savings Accounts
Money Market Accounts
FNB Debit Card
Terms

By submitting this application, I (each person jointly and severally) apply for the account(s) and Check Card(s) listed above and a personal identification number.  As an account owner, I am subject to all of its bylaws and rules as amended from time to time.  I certify that all information given is correct.  I understand and agree that for all accounts for/or. or any one of us opens in the future is governed by this application, and all persons listed here will be owners, except as provided as follows: If I wish an account to have (as applicable) fewer, additional or different owner(s), a completed, signed application for the specific account must be submitted to and accepted by the First National Bank of Waterloo.

 

I agree to the terms and conditions for any accounts or services that I have now or in the future, and as they change from time to time.  I agree at any time you may request information from others about my credit or accounts and that you provide to others experience information about me or my accounts with First National Bank of Waterloo.

I/We AGREE with the above statement.