Personal Deposit Account Application

 

Thank you for your interest in Jonestown Bank & Trust Co.  Part of our mission, as a community bank, is to provide the best possible service to our customers. To meet this goal we limit on-line applications to existing customers and other residents of our geographic area.

Our primary service area is Lebanon County, Pennsylvania. Our secondary service area is Western Berks, Southern Schuylkill, Eastern Dauphin, and Northern Lancaster Counties, Pennsylvania.  If you are not a current JBT customer or a resident of these areas, we may deny your application to open a deposit account solely based on that fact.

We invite you to submit this application by completing the form below and clicking on the "Submit" button at the end of the form. Before we can open your deposit account, we must have your signature and an initial deposit. You may not use a money order or a check that is not made payable to you to open the account. If you wish to open this account by transferring money from an existing JBT account, please specify the account number here:

We may obtain your signature by sending you a signature card in the mail or by requesting that you visit one of our offices. Please select the branch office that would be most convenient for you.

Within three business days of receipt of your application, we will send you an acknowledgement of receipt and the appropriate account disclosures as required by federal law. If you have any questions about our products or need further assistance, please email us at eservice@bankjbt.com . Warning:  email is not secure; do not send sensitive information by way of this link.

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, AND DATE OF BIRTH, SOCIAL SECURITY NUMBER, AND OTHER INFORMATION THAT WILL ALLOW US TO IDENTIFY YOU. WE MAY ALSO ASK TO SEE YOUR DRIVER'S LICENSE OR OTHER IDENTIFYING DOCUMENTS.

Step 1 – Personal Information

 

 

Choose an account type:

Name

 

 

 

 

Social Security Number
- -

 

Date of Birth
(MM/DD/YYYY)
/ /

 

Home Phone
( ) -

 

Mother's Maiden Name

 

 

 

 

Driver's License Number
or Registered ID

   

State

 

Issued
(MM/DD/YYYY)
/ /

 

Expires
(MM/DD/YYYY)
/ /

 

 


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

 

Years There

 

States Resided in Past 5 Years

 

 

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)
/ /

 

Residential Address (if different than above)

 

City

 

State

 

Zip

 

Employer

 

Position

 

Work Phone and Extension
( ) -   

 


Step 4 – Initial Deposit and Source

 

 

Initial Deposit
$

 

Source

 


Step 5 – ATM or Debit Card Application

 


ATM Debit / Checking Card

Comments

 




Jonestown Bank & Trust Co. reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, you grant us full permission to do so.

This document is being secured using SSL encryption provided by your browser. Your information will be encrypted when using this form while in transit between your browser and JBT.

OR

If you desire, this form may be printed and mailed to us at the address below.

Please print this form using the "PRINT" button below, sign it, and mail it to us at:

_____________________________________________ Signature

_____________________________________________ Co-applicant Signature (if applicable)

Jonestown Bank & Trust Co

ATTN: Internet Banking Services
421 E. Penn Avenue
Cleona, PA 17042