IMPORTANT INFORMATION
ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
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. What this means for you: When you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

Unlawful Internet Gambling Notice. Restricted transactions as defined in Federal Reserve Regulation GG are prohibited from being processed through this account or relationship. Restricted transactions generally include, but are not limited to, those in which credit, electronic fund transfers, checks, or drafts are knowingly accepted by gambling businesses in connection with the participation by others in unlawful Internet gambling.
 Checking Account Application
Personal Account Information
All fields marked with a * are required.
Step 1 - Personal Information
* Choose an account type: Free Checking Free Campus Checking Free Senior Checking
  First Rate Checking FCB Prime Advantage
  Preferred Rate Checking Century Preferred Money Market
*Name
*Social Security Number
- -
*Date of Birth (MM/DD/YYYY)
/ /
*Home Phone
( ) -
*Driver's License Number
or Registered ID
  *State
*Issued (MM/DD/YYYY)  / / *Expires (MM/DD/YYYY)  / /
*Email Address
Step 2 - Address Information
*Residential Address ** (Required, not a P.O. Box)
*City
  *State
  *Zip
Years There
Mailing Address (if different than above)
City
  State
  Zip
** If length of time at current address is less than two years, please complete the following:
Previous Address (Required, not a P.O. Box)
City
  State
  Zip
Employer Name
Position
Work Phone and Extension
( ) -   
Step 3 - Joint Account Holder Information (If Applicable)
Name (Co-Applicant)
Social Security Number
- -
  Birth Date
(MM/DD/YYYY)
/ /
Driver's License Number
or Registered ID
    State

Issued
(MM/DD/YYYY)
/ /
Expires
(MM/DD/YYYY)
/ /
Address (if different than above)
City
  State
  Zip
Employer
Position
Work Phone and Extension
( ) -   
Comments
Certification
Certification
Under penalties of perjury, I certify that the following information is correct.
 
TAXPAYER ID NUMBER: My correct Taxpayer Identification Number (TIN) is shown above.
 
BACKUP WITHHOLDING: I am not subject to backup withholding because either I have not been notified of being subject to backup withholding as a result of failure to report all interest or dividends, or the IRS has notified me that I am no longer subject to backup withholding.
 
As a condition of acceptance of a checking account with FCB, I authorize you (FCB) to obtain a copy of my current credit report and subsequent reports for the purpose of an update, renewal or extension of credit, or opening of deposit accounts.