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: BankLiberty has safeguards in place to make sure your account information is secure. To learn more about what we do with personal information, view our Privacy Policy.

Online Applicants must reside in Clay, Platte, Clinton, Jackson, Ray counties of Missouri or Leavenworth, Johnson, Wyandotte counties of Kansas. In order to complete this online application you will need a social security number and a MO/KS Driver's License. If you have another form of identification, we ask that you stop by any of our 13 locations to open your account. If you are NOT a US Citizen or a Permanent Resident Alien, we ask that you stop by any of our 13 locations to open your account. DO NOT complete this form online. You must be at least 18 years old. ChexSystems will be run on all applicants when identification is presented at the branch. All applicants must pass ChexSystems to open an account. We look forward to having your business. 

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 on-line 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". Completing this application online will take approximately 5-10 minutes. If you need help completing this application please call us at 816-407-9200 during business hours.

2. To safeguard your privacy, CLOSE your browser and restart it again after using this form. This form is NOT saved in your computer's memory when you close your browser.

3. We will contact you during business hours shortly after you have submitted this application to arrange the completion of your paperwork. Depending on the type of account you select, a minimum opening deposit ranging from $50.00 to $25,000.00 is required when you visit the branch to sign your paperwork. You may also be requested to present your Social Security card, Driver's License, or other documentation.

Primary or Joint Account Holder Information
Are all account holders a US Citizen or Permanent Resident Alien? (required)
If no please visit a branch to apply for an account
Are you an existing BankLiberty customer?
First NameMiddle InitialLast Name
Date of BirthSocial Security No.Your E-mail Address
Driver's License No.Driver's License StateDate IssuedExpiration
Phone 1Phone 2
(required)
EmployerOccupation Length of Employment
Address Information
Physical street address only- No PO Box
How long have you lived at the above address?
Additional Account Holder
Are you an existing BankLiberty customer?
First NameMiddle InitialLast Name
Date of BirthSocial Security No.Your E-mail Address
Driver's License No.Driver's License StateDate IssuedExpiration
EmployerOccupation Length of Employment
Phone 1Phone 2
Address Information
Physical street address only- No PO Box
How long have you lived at the above address?
Additional Account Holder
Are you an existing BankLiberty customer?
First NameMiddle InitialLast Name
Date of BirthSocial Security No.Your E-mail Address
Driver's License No.Driver's License StateDate IssuedExpiration
Employer Occupation Length of Employment
Phone 1Phone 2
Address Information
Physical street address only- No PO Box
How long have you lived at the above address?
Account Holders Relationship
If opening a joint account are the account holders married to each other?
Beneficiaries
If you would like beneficiaries on your account please list them below:
First Name, Middle Name, Last Name
Beneficiary Name
Beneficiary Name
Beneficiary Name
Beneficiary Name
Do you plan to use this account to send domestic wires?
Do you plan to use this account to send international wires?
If you have a separate mailing address please enter here:
e.g. PO Box
Which branch would you like to come in and sign your paperwork? (required)
A representative will call when your documents are ready to sign.
I/We would like to apply for the following account(s):
Checking Accounts
Savings Accounts
Money Market Accounts
MasterCard Debit Card
eServices
Please select how you would like to receive your bank statements.
Only select one

The Internal Revenue Service requires the accuracy of the taxpayer identification number to be certified for each account opened and to disclose whether or not you are subject to backup withholding. This certification will be completed at account opening.

By submitting this application, I (each person jointly and severally) apply for the account(s) and debit card(s) listed above. I certify that all information given is correct. All persons listed here will be owners, except those identified as beneficiaries.   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 BankLiberty.

I/We AGREE with the above statement