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FSB Credit Card Application
Submitter Information (Required)
First Name (required)
Last Name (required)
Resolve the errors marked in red before submitting again.

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.

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Application Disclosure: 
Read the Flanagan State Bank credit card application disclosure by clicking here before applying. 

Personal Information
Type of Application
First NameMiddleLast Name
(required) (required) (required)
Social Security NumberDate of BirthMother's Maiden Name
(required) (required) (required)
Physical Street Address (required)
Mailing Address If different than current address
Mobile Phone* (required)
Home Phone
Employment
Employer NameOccupation

 

 
Work PhoneMonth/Year Employment Began

 

 
Financial
Annual Income** (required)
Monthly Housing Cost (required)
Housing Status (required)
If you own, does your Monthly Housing Cost include taxes and insurance?
Joint Application or Authorized User - Part Two
First NameMiddleLast Name

 

 

 
Social Security NumberDate of BirthMother's Maiden Name

 

 

 
Physical Street Address
Mailing Address If different than current address
Mobile Phone*
Home Phone
Joint or Authorized User Employment Information
Employer NameOccupation

 

 
Work PhoneMonth/Year Employment Began

 

 
Joint Applicant Financial Info - Only complete this portion if applying for joint credit
Joint Applicant Annual Income**
Joint Applicant Monthly Housing Cost
Joint Applicant Housing Status
If you own, does your Monthly Housing Cost include taxes and insurance?
Type Name to Electronically Sign Application - Main/Individual Applicant (required)
Type Name to Electronically Sign Application - Joint Applicant
Applicant(s) Statement

I/we certify that everything I/we have stated in this Credit Application and on any other documents submitted to you are true and correct to the best of my/our knowledge. I/we understand that I/we must update the information contained in this Credit Application if either my/our financial condition materially changes or you make a request to me/us orally or in writing. I/we certify that  I/we have read and agree to the Application Disclosure and the Program Terms and Conditions. 

I/we understand that Flanagan State Bank will retain the Credit Application whether or not it is approved. I/we authorize Flanagan State Bank to request one or more consumer reports, to check and verify my/our credit and employment history, and to answer questions others may ask Flanagan State Bank about your credit experience with me/us. 

(required)