New Account Application
Simply follow the prompts to complete the form below, and we'll start processing your application right away. Your account opening package and account disclosures will be mailed to you along with a postage-paid return envelope. Complete the package as instructed and return it to us with your opening deposit. Your account will be opened on the date we receive your completed package.
* Indicates Required Fields
Primary Applicant Personal Information
* First Name:     Middle Initial:   * Last Name:    
Primary Applicant Mailing Address
* Street:    
* City:     * State:    * Zip:    
Primary Applicant Physical Address
* Street:    
* City:     * State:    * Zip:    
Primary Applicant Previous Address (If less than 2 years at current address)
Street:  
City:   State: Zip:  

If you have lived in any other states in the past five years, please list them here:
 

* Email:    
* Driver's License Number:     * Issue Date:    
* Driver's License State:    * Expiration Date:    
* Home Phone:     Work Phone:  
* Social Security Number:    
* Date Of Birth:     * Mother's Maiden Name:    
Primary Applicant Employment Information
Occupation:   Business Name:  
Business Address:  
Business City:   Business State: Business Zip:  
Business Phone:   Years Employed:  

Household Annual Income:
Joint Applicant Personal Information (complete joint applicant section only if applying for joint account ownership)
First Name:   Middle Initial:   Last Name:  
Joint Applicant Mailing Address
Street:  
City:   State: Zip:  
Joint Applicant Physical Address (If different than above)
Street:  
City:   State: Zip:  
Joint Applicant Previous Address (If less than 2 years at current address)
Street:  
City:   State: Zip:  

If you have lived in any other states in the past five years, please list them here:
 

Email:  
Driver's License Number:   Issue Date:  
Driver's License State: Expiration Date:  
Home Phone:   Work Phone:  
Social Security Number:  
Date Of Birth:   Mothers Maiden Name:  
Joint Applicant Employment Information
Occupation:   Business Name:  
Business Address:  
Business City:   Business State: Business Zip:  
Business Phone:   Years Employed:  

Household Annual Income:
New Account Information (Please choose which type of checking account you would like to open)
Checking Account Type: Initial Deposit Amount:$  
Account Ownership: Individual Joint**
** Please complete joint owner information above if applying for Joint Account Ownership
Source of Deposit
Mail Check
Transfer from an existing First City Bank deposit account (accounts must be in the same name)
Account Number:  
Transfer from my checking account at another Bank (accounts must be in the same name)
Bank Name:   Account Number:   Routing Number:  
Optional Savings Accounts
Would you like to open a savings account as well? If so, please choose from the following accounts:
Savings Account Type: Initial Deposit Amount:$   $100 minimum to open
Money Market Account Type: Initial Deposit Amount:$   $100 minimum to open
Certificate Of Deposit Type: Initial Deposit Amount:$   $1,000 minimum to open
Additional Account Offerings
Please check products that you are interested in and we will mail you the application(s) that require your signature.
Check Card ATM Only Card Direct Deposit

USA PATRIOT Act Notice: 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.  Your name, address, date of birth and other information collected in this application will allow us to identify you. We may also ask for your driver's license or other identifying documents.
By submitting this application, the applicant and any co-applicant (each referred to as "I", "my", and "me") each represent that all the information in this application is true and correct. I authorize you to obtain any information about me that you believe is necessary to evaluate this application, including consumer reports from consumer reporting agencies. I agree to accept the terms of this account which will be mailed to me upon receipt of this application.

Print and retain this form for your records. As a reminder, accounts will not be opened until the required documentation (contained in your account opening package sent via U.S. mail) is received by First City Bank.

Please use the box below for any comments or questions
 

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