Personal Account. Branch: Banker: How did you hear about us:



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Personal Account Branch: Banker: How did you hear about us: Ownership: Type of Account: Type of Account: First Signer: Street: City: Zip Code: State: Phone: Work: Cell: Home: Email Address: Drivers License # Issue Dt: Exp Dt: Second ID Description & #: Social Security # Birth : Employer: Occupation: Second Signer: Street: City: Zip Code: State: Phone: Work: Cell: Home: Email Address: Drivers License # Issue Dt: Exp Dt: Second ID Description & #: Social Security # Birth : Employer: Occupation: Services: Internet Banking: Username: E-statements First Signer Bk Card: Second Signer Bk Card: Order Checks: Starting Check Number: 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 to 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. By signing below, I authorize Freedom Bank to verify the information provided at account opening. MEMBER FDIC FOR INTERNAL USE CARD# CARD# COMPLETED BY: DATE COMPLETED: : :

Business Account Branch: Banker: How did you hear about us: Ownership: Type of Account: Business Name: Address: State: Phone: Type of Business: Tax ID#: Zip: City: SERVICES: Online Banking: Username: E-statements: Debit Card: Order Checks: Starting Check #: Is the business involved in Internet Gaming/Gambling: PLEASE ATTACH COPIES OF IDENTIFICATION FOR ALL SIGNERS Name: Title: SSN#: DOB: Phone: Address: City: State: Zip: Primary ID: 2nd ID: Email: Employer: Occupation: (if retired, previous employer/occupation) Is the customer or a close associate or family member of a senior foreign political figure: Name: Title: SSN#: DOB: Phone: Address: City: State: Zip: Primary ID: 2nd ID: Email: Employer: Occupation: (if retired, previous employer/occupation) Is the customer or a close associate or family member of a senior foreign political figure: Name: Title: SSN#: DOB: Phone: Address: City: State: Zip: Primary ID: 2nd ID: Email: Employer: Occupation: (if retired, previous employer/occupation) Is the customer or a close associate or family member of a senior foreign political figure: 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 to 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. By signing below, I authorize Freedom Bank to verify the information provided at account opening. : : MEMBER FDIC FOR INTERNAL USE CARD# CARD# COMPLETED BY: DATE COMPLETED:

Direct Deposit Authorization Form To: Company/Organization Name Company Address Subject Account Number From: Your Name Your Address To Whom It May Concern; Please redirect my direct deposit for the above account number to my new bank account as instructed below. Freedom Bank Routing Number: 063115741 Account Type: Checking Savings Effective: Deposit Instructions: Immediately Beginning / / Deposit the entire amount to account number Deposit $ to account # and the remainder to account #. If you have any questions about this request, please contact me at the following number:. (Attach voided check from new account)

Payment Authorization Form To: Company/Organization Name Company Address Subject Account Number From: Your Name Your Address To Whom It May Concern; Please redirect my automatic payment for the above account number to my new bank account as instructed below. Freedom Bank Routing Number: 063115741 If you have any questions about this request, please contact me at the following number:.

Account Closure Request Form To: From: Bank Name Your Name Your Address To Whom It May Concern; Please accept this letter as authorization to close the following account(s) with your financial institution. Account # Account # Account # Type Type Type Please send any funds remaining to the address above. If you have any questions about this request, please contact me at the following number:.

Account Closure Checklist Before closing your account, make sure the following have been completed: All checks have cleared your existing account All automatic withdrawals and deposits have been switched to your new Freedom Bank account Remaining checks, deposit slips, debit and/or ATM cards have been destroyed