Equal Housing Lender | Member FDIC
Privacy Statement

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

Currently, we are only accepting online applications from the following Georgia counties: Chatham, Bryan, Effingham, Bulloch and Liberty; as well as the South Carolina counties of Jasper and Beaufort.

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

The bank is required to provide adequate notice to new account customers, beneficial owners and the controlling person that the bank is requesting information to verify their identities.  The notice describes the bank’s identification requirements and is posted in the lobby area to allow customers to view prior to opening an account.  The following statement is the bank’s sign:


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 on personal accounts identifies each person who opens an account.  In addition, on legal entity accounts, we will require identification on beneficial owners and controlling person.

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


If you request to open an account or become a signatory on an account with the Bank and the Bank has not previously verified your identity under the new regulatory requirements, the Bank will request documentary verification of your identity, such as driver’s license or passport and/or it will verify your identity through other non-documentary methods.  Similar identification requirements apply to business entities such as corporations, limited liability companies and partnerships.

In all cases, protection of our customers’ identity and confidentiality is the Bank’s pledge to you.

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.

1. Complete Application and click "Submit Application".
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.

County of Residence
APPLICANTS MUST RESIDE IN ONE OF THE FOLLOWING COUNTIES. In which of the following counties do you currently reside? (required)
Primary Joint Account Holder Information
First NameMiddle InitialLast Name

Date of BirthSocial Security No.Your E-mail Address

Driver's License No.Driver's License StateDriver's License Expiration

Home PhoneWork Phone

Address Information
Subject to backup withholding
Joint Account Holder (with right of survivorship)
First NameMiddle InitialLast Name

Date of BirthSocial Security No.Your E-mail Address

Driver's License No.Driver's License State

Home PhoneWork Phone

Address Information
Subject to backup withholding
Account Titling Information
In Trust For
NameSocial Security No.

NameSocial Security No.

I/We would like to apply for the following account(s):
Checking Accounts
Savings Accounts
Money Market Accounts
Visa Check/ATM Card
Visa Check Card
ATM Card

The Internal Revenue Service does not require your consent to any provision of this document other than certification required to avoid backup withholding. See Taxpayer Identification Number Certification below.

Taxpayer Identification Number Certification: Under the penalties of perjury, I certify that

(1) the number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and

(2) I am not subject to backup withholding because

    (a) I am exempt from backup withholding, or

    (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding, or

    (c) the IRS has notified me that I am no longer subject to backup withholding as a result of failure to report all interest or dividends, or

    (d) the IRS has notified me that I am no longer subject to backup withholding, and

(3) I am a U.S. person (including U.S. resident alien).

Certification Instructions: You must cross out item (2) above if you have been notified by the IRS that you are currently subject to backup withholding because of under-reporting interest or dividends on your tax return unless you have received another notification form from the IRS that you are no longer subject to backup withholding.

By submitting this application, I (each person jointly and severally) apply for the account(s) and Check/ATM 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, 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 Carver State Bank.

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 Carver State Bank. 

I agree to give Carver State Bank written notice immediately upon change of my name, address, employment or any other pertinent information contained herein.