New Account Application

Primary Account Info
Name(*)

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Email(*)

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Business Name

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D.O.B(*)

Please enter your date of birth

(MM/DD/YY)
SSN(*)

Please enter your social security number
PO Box

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Street Address

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City(*)

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State(*)

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Zip(*)

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Driver's License Number(*)

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Driver's License State(*)

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Employer(*)

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Home Phone(*)

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(000-000-0000)
Work Phone(*)

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(000-000-0000)
Joint Owner
Name

please enter your name
Email

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Business Name

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D.O.B

Please enter your date of birth

(MM/DD/YY)
SSN

Please enter your social security number
PO Box

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Street Address

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City

Please enter your city
State

Please enter your state
Zip

Please enter your zip
Driver's License Number

Please enter your Driver's License Number
Driver's License State

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Employer

Please enter your employer
Home Phone

Please enter your home phone

(000-000-0000)
Work Phone

Please enter your work phone

(000-000-0000)
OWNERSHIP OF ACCOUNT
Commerical Accounts

Sole Proprietorship
Corporation Profit
Corporation Non-Profit
Unincorporated Association
Other
Partnership
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ACCOUNT INFORMATION
Initial Deposit

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Previous Bank

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Check Options

Include Driver's License on Checks
Include home phone number on checks
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CHECK ONE OR MORE OF THE ACCOUNTS BELOW TO APPLY FOR:

Hometown Reward Checking Account
Hometown Advantage Checking Account
Hometown Select Checking Account
Hometown Prestige Checking Account
Hometown Premier Money Market Account
Insured Money Market Account
Business Checking Account
Savings Account
Business Savings Account
Christmas Club Account with Automatic Transfer
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CHECK ONE OR MORE OF THE SERVICES BELOW TO APPLY FOR:

MasterCard Debit Card
Internet Banking
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I certify that I am at least 18 years of age and I have accurately and fully completed all items on this application. Under penalties of perjury, I certify that:
1. The social security number (SSN) and/or tax payer identification number (TIN) shown above is my correct number;
2. I am NOT subject to backup withholding because (a) I am exempt from backup witholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the Internal Revenue Service has notified me that I am no longer subject to backup withholding; and
3. I am a U.S. person (including a U.S. resident alien).
Or check all that apply:

I have been notified that I am subject to backup withholding.
I am not a U.S. citizen or resident (complete W-8) form.
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The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

Please note, this application is subject to verification and approval. In order for us to process your application correctly, we may need to contact you to verify some of the information or request additional documentation. When you submit this application, you certify that everything stated above is true and accurate. When you submit this application, you also agree that this Institution reserves the right to review your credit history through an authorized bureau.

If you have any questions, please contact us at (641) 484-2980, or by e-mail at mwerner@banktoledo.com.

By clicking below, I hereby certify that everything I have stated above is correct. You may keep this application whether or not it is approved. By clicking below, I authorize you to check my credit and employment history and verify other information which I have provided to you.
Please enter the letters shown to continue

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State Bank of Toledo

Important Information About Procedures for Opening a New Account:

Primary Account Info

Joint Owner

OWNERSHIP OF ACCOUNT

ACCOUNT INFORMATION