Deposit Account Application

First Citizens National Bank Online limits applications to its defined market area of the following Ohio counties: Crawford, Delaware, Hancock, Hardin, Marion, Morrow and Wyandot. The Bank does not accept brokered deposits.

 

You will be required to come into the nearest Banking Center to sign all the necessary documentation. We will contact you with the details.

 

*Required Fields

 

Acct. Holder Info.

PRIMARY OWNER

JOINT OWNER

Name*
Business Name
D.O.B*
SSN*
Email
Street Address*
City*
State*
Zip Code*
Drivers' License Number*
Drivers' License State*
Employer
Home Phone
Work Phone

OWNERSHIP OF ACCOUNT

Personal Accounts:

Individual

Trust - Separate Agreement

Joint - with Survivorship

Pay-on-death

 

List Beneficiaries:

 

Commercial Accounts:

Sole Proprietorship

Corporation For Profit

Corporation Not For Profit

Partnership

Other

If Other, Please explain:

Choose one or more of the accounts to apply for:

Regular Checking

NOW Checking

Super NOW Checking

First Rate Free Checking

Freedom Checking

Money Market Account

Statement Savings

IRAs

Certificates of Deposit

Choose one or more of the services to apply for:

MAC ATM Card

Combined Statements

Telebanking

First Check Card

Safe Deposit Box

Savings Overdraft Protection

Cash Reserve

If you have any questions, please contact us at (419) 294-2351, or by email at FCNB@udata.com.

In order for us to process your application correctly, we may need to contact you to verify some of the information or request more necessary documentation. This information will also allow us to better satisfy our regulatory requirements to "KNOW YOUR CUSTOMER." We appreciate you supplying the information for that purpose.