Online Banking Access
Personal Services

First Friends Checking Application


* indicates a required field

Ownership

Single Owner (individual)
Joint (right to survivorship)
Joint (no right to survivorship)
Payable on Death (POD)

Primary Account Owner

*Name (First M. Last)
*Date of Birth (mm/dd/yyyy):
*SSN:
*Address
(P.O. Box is inappropriate in this field)
*City, State Zip-Plus4 , -
 


Mailing Address Same as above
(if different than physical address)
City, State Zip-Plus4 , -
*Home Phone Number
Employer Name
Self-employed?
Work Phone Number
Position/Occupation
*Driver's License Number: *State:
Issue Date
Expiration Date
*E-mail

Joint Account Owner

 (if you selected joint account ownership)
Name (First M. Last)
Date of Birth (mm/dd/yyyy):
SSN:
Employer Name
Self-employed?
Work Phone Number
Position/Occupation
Driver's License Number: State:
Issue Date
Expiration Date
   
If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit (please check the box below if your agree):
Borrower Co-Borrower
   

Payable on Death Beneficiary

 (if you selected POD ownership)
Name (First M. Last)
SSN:
Phone Number
Address
City, State Zip-Plus4 , -

Deposit Information

*Initial Deposit
*Initial Deposit Type

Taxpayer Identification Number Certification

*Social Security Number(s) The Social Security Number(s) shown above is my correct SSN.

Backup Withholding 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.

Exempt Recipients I am an exempt recipient under the Internal Revenue Service Regulations.

Nonresident Alien 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 authorize First National Bank of Griffin to obtain a copy of my current credit report as a condition of acceptance of this application and for the purpose of extension of or renewal of credit.

I would like to access this account through Online Banking.

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Disclosures


* indicates a required field