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* indicates a required field
Ownership
Single Owner (individual)
Joint (right to survivorship)
Joint (no right to survivorship)
Payable on Death (POD)
Account Type
Account Type
Savings
Checking
Primary Account Owner
*Name (First M. Last)
*Date of Birth (mm/dd/yyyy)
Persons under 13 years of age must have a parent or legal guardian complete this application.**
*Social Security Number:
*Address
*City
,
State
Zip
,
*Home Phone Number
Home Phone Number, Area Code
(
)
Home Phone Number, Prefix
-
Home Phone Number, Suffix
*Work Phone Number
(
Work Phone Number, Area Code
)
Work Phone Number, Prefix
-
Work Phone Number, Suffix
*Driver's License Number
*State
*Issue Date
*Expiration Date
*E-mail
Employer Name
Employer Phone Number
(
Employer Phone Number, Area Code
)
Employer Phone Number, Prefix
-
Employer Phone Number, Suffix
Secondary Account Owner
(if you selected secondary account ownership)
*Name (First M. Last)
*Date of Birth (mm/dd/yyyy)
*Social Security Number
*Address
*City
,
*State
*Zip
,
*Home Phone Number
Home Phone Number, Area Code
(
)
Home Phone Number, Prefix
-
Home Phone Number, Suffix
*Work Phone Number
Work Phone Number, Area Code
(
)
Work Phone Number, Prefix
-
Work Phone Number, Suffix
*Driver's License Number
*State
*Issue Date
*Expiration Date
*E-mail
Employer Name
Employer Phone Number
Employer Phone Number, Area Code
(
)
Employer Phone Number, Prefix
-
Employer Phone Number, Suffix
Payable on Death Beneficiary
(if you selected POD ownership)
*Name (First M. Last)
*Social Security Number
*Phone Number
(
)
-
*Address
*City
,
*State
*Zip
,
Deposit Information
*Initial Deposit
*Initial Deposit Type
Cash
Check
Transfer
How did you hear about Franklin Bank?
*Please select one:
---
I am an existing customer
Referral from family/friend
Social Media
Radio Ad
Billboard
Print Ad
Internet Search
Digital Ad
Drove by Branch
Other
*Other:
Taxpayer Identification Number Certification
The Social Security Number(s) shown above is my correct SSN.
I am not subject to backup withholding either because I have not been notified that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding.
I am an exempt recipient under the Internal Revenue Service Regulations.
I am not a United States person, or if I am an individual, I am neither a citizen nor a resident of the United States.
I certify under penalties of perjury the statements checked in this section are true.
I would like to access this account through Online Banking.
I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand and agree that completing this form does not obligate Franklin Bank to open the account. Reasons could include, but are not limited to, applicants not in good standing with Franklin Bank or another financial institution or applicants residing outside of our servicing area.
* indicates a required field
**See COPPA Policy
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