Personal Deposit Account Application

PERSONAL DEPOSIT ACCOUNT APPLICATION

Thanks for your interest in opening a personal deposit account at SouthernTrust Bank. By completing this secure online application you will be able to minimize the time spent at the bank when opening an account.

After we receive your application, a bank representative will contact you to set up a time to stop in and sign the necessary paperwork. During the meeting at the bank, your banker will ask you to:

Sign the application
Provide an initial deposit
Provide required IDs (in accordance with the USA Patriot Act)
Provide verification of address

Before you begin please review the various personal checking, savings, and certificates of deposit accounts we offer and select the one that is the right fit for you.

SouthernTrust Bank values your privacy and your business. Please review our Privacy Policy prior to completing this application form. A second browser window will open. When finished, just close that window to return to the application. By submitting the online application you certify that at least one account owner is age 18 years or older and all owners are legal residents of the United States. SouthernTrust Bank reserves the right to deny any account opening application.

Branch Location

In order for us to correctly route your application, please select the Branch that is most convenient for you.

Deposit Account Information

Select the type of deposit account you wish to open (choose one):

Select the name of the account you wish to open (choose one):

Account Ownership Type

Select the type of ownership you wish to have for this account (choose one):

Account ownerships other than Individual and Joint with Survivorship cannot be applied for online due to their additional complexities. Please visit one of our branches to open an account with these more complex ownership types.

Owner Information

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. Additionally, if you are new to SouthernTrust Bank we will generate a ChexSystems report to review your previous banking history.

* indicates a required field

Primary Owner

Full Legal Name (including middle initial)*

Physical Address*

City, State Zip*

Mailing Address - Please enter your mailing address below (if your mailing address is different than the physical address provided above).

Mailing Address

City, State Zip

Date of Residence

Phone Numbers:

Primary Number (Select one)*:

Home

Mobile

Work

Alternate Number (Select one):

Home

Mobile

Work

First form of identification*
(must be a government issued photo ID)

ID# *
Issuing State:
Issue Date*:
Expiration Date:*
Address on ID:*

Second form of identification Identification Type:

ID# *
Issuing State:
Issue Date:
Expiration Date:
Address on ID:

Social Security Number*

Date of Birth*

Email Address

Current Employer

Employer Phone Number

Mother's Maiden Name*

Occupation*

Secondary Owner

Full Legal Name (including middle initial)*

Physical Address*

City, State Zip*

Mailing Address - Please enter your mailing address below (if your mailing address is different than the physical address provided above).

Mailing Address

City, State Zip

Date of Residence

Phone Numbers:

Primary Number (Select one):*

Home

Mobile

Work

Alternate Number (Select one):*

Home

Mobile

Work

First form of identification*
(must be a government issued photo ID)

ID# *
Issuing State:
Issue Date:*
*Expiration Date:
*Address on ID:

Second form of identification Identification Type:

ID# *
Issuing State:
Issue Date:
Expiration Date:
Address on ID:

Social Security Number*

Date of Birth*

Email Address

Current Employer

Employer Phone Number

Mother's Maiden Name*

Occupation*

Other

Please check the box below if you are interested in an ATM/Debit Card:

ATM/Debit Card	(Maximum of 2)
Name on Card 1
Card Type (select one):
Name on Card 2
Card Type (select one):

Deposit Information

Initial Deposit Amount (must be in US dollars)*

Minimum deposit amounts required to open:

CHECKING ACCOUNTS		SAVINGS ACCOUNTS		CERTIFICATES OF DEPOSIT
ACCOUNT NAME	MINIMUM DEPOSIT TO OPEN	ACCOUNT NAME	MINIMUM DEPOSIT TO OPEN	CD TERM	MINIMUM DEPOSIT TO OPEN
SOUTHERNSTARTER	$50.00	SOUTHERNSAVINGS	$50.00	All	$1,000.00
SOUTHERNGREEN	$100.00	SOUTHERNSAVINGS PLATINUM	$50.00
SOUTHERNSILVER	$100.00	SOUTHERNKIDS	$10.00
SOUTHERNGOLD	$100.00	SOUTHERNKIDS PLATINUM	$10.00
MONEY MARKET	$2,500.00	CHRISTMAS CLUB	$10.00

SouthernTrust Bank values your privacy and your business. Please review our Privacy Policy prior to completing this application form. A second browser window will open. When finished, just close that window to return to the application. By submitting this application I certify that at least one account owner is age 18 years or older and all owners are legal residents of the United States. SouthernTrust Bank reserves the right to deny any account opening application.

After you press the Submit Application button below, a customer service representative will contact you within 1 business day to arrange a date and time for you (and your joint owner if a joint account) to visit the bank to complete the account opening process. Please remember to bring your opening deposit (check or cash) and the required identification documents to that visit.

If you have a preferred customer service representative that you would like to meet with for this process, please enter their name here.

The information I have provided is correct to the best of my knowledge. I authorize SouthernTrust Bank to check credit and/or employment history should it deem necessary.