Business Deposit Worksheet Test

APPLICATION FOR A DEPOSIT ACCOUNT WITH CBOTS - Step 1 of 8

Applicant Information

Type of Business *

Business Name *

Nature of Business *

Examples may include: Restaurant, Convenience Store, Accounting Firm, Law Office, Retail store, etc.

Street Address of the Business *

Address Line 1

City

State

Zip Code

Is the mailing address the same as the street address? *

Business Phone Number *

Do you need the account to have special titling?

Titling provides a way to better identify or label the accounts. Examples include general account, special account, tax account, and operating account.

Drivers License / ID Number *

Driver's License Issue Date *

Driver's License Expiration Date *

ACCOUNT INFORMATION

Deposit Product *

Checking Account
Savings Account

Thank you for your application for a deposit account with Citizens Bank of the South. Your application process is almost complete.

Please select your Customer Service Representative *

Acknowledgement - E-SIGN Disclosure and Consent Agreement *

I read, understand, and consent to the E-SIGN Disclosure and Consent Agreement

This E-Signatures Authorization Acknowledgment And Consent will also be referred to in this document as the "Agreement" and constitutes the full agreement by and between Citizens Bank of the South ("Financial Institution") and you (as a "Consenting Party"), with respect to the use of electronic signature.
Financial Institution and Consenting Party agree to the following:
1. Each Consenting Party authorizes Financial Institution to use an electronic signature of the Consenting Party for all documents, agreements, attachments, addendums including, without limitation, all deposit and lending related documents such as account agreements, loan agreements, security agreements, mortgages, deeds of trust, guaranties and hypothecations (collectively, the "Documents") in any way connected to the transaction (''Transaction") being entered into between the Consenting Party and the Financial Institution. This consent is specifically to permit an electronic signature (as of the nature then in use by the Financial Institution) in lieu of hand-written signatures on any one or more of the Documents.
2. Financial Institution consents to accept such signatures as true, correct and binding signatures of the Consenting Party and to enter into the Transaction in reliance thereon.
3. Each Consenting Party agrees that its electronic signature will be enforceable as and to the full extent of a hand-written signature as an original for enforcement/enforceability of the Documents containing the electronic signature(s), whether in court (state or federal), arbitration or otherwise. Consenting Party will not raise any defenses or invoke regulatory or statutory claim attempting to invalidate the enforceability of the Documents to which the electronic signature is affixed.
NOTICES. Any notice from Financial Institution to Consenting Party shall be deemed given when mailed, postage paid, and addressed to any Consenting Party at the last address furnished by any Consenting Party to the Financial Institution. Any notice from Consenting Party to Financial Institution shall be deemed given when mailed, postage paid, and addressed to the Financial Institution at its principal place of business.

ENTIRE AGREEMENT. This Agreement contains and constitutes the entire understanding between Financial Institution and each Consenting Party regarding the subject matter hereof and may not be modified, amended, or terminated except by written agreement signed by Financial Institution and each Consenting Party that such modification, amendment or termination affects. All prior or subsequent oral agreements and/or discussions relating to this Agreement are superseded by this Agreement. Further, in the event of any conflict between the terms and provisions contained in this Agreement and any other document(s) relating to use of electronic signatures, the terms and provisions of this Agreement shall control.

BINDING EFFECT. The obligations hereof shall bind the heirs, executors, administrators, successors, and assigns of each Consenting Party, and all rights, benefits and privileges hereby conferred on Financial Institution shall be and hereby are extended to and conferred upon and may be enforced by its successors and assigns. Further, if any Consenting Party is a partnership, the obligations hereof shall continue in force, and apply, notwithstanding any change in the membership of such partnership, whether arising from the death or retirement of one or more partners or the accession of one or more new partners.

ENFORCEABILITY. Whenever possible each provision of this Agreement shall be interpreted in such manner as to be effective and valid under applicable law. If any provision of this Agreement shall be prohibited by or invalid under applicable law, such provision shall be ineffective only to the extent of such prohibition or invalidity, without invalidating the remainder of such provision or the remaining provisions of this Agreement.

HEADINGS. Section headings/titles are for convenience only and are not to be used in construing or interpreting this Agreement.

GOVERNING LAW. This Agreement shall be governed by the laws of the state of Georgia except to the extent that federal law is controlling.

By clicking accept and submitting your online deposit application, Financial Institution and each Consenting Party acknowledge reading, understanding and agreeing to all of its provisions.

Acknowledgement - Patriot Act *

I read and understand the requirement of CBOTS to attempt to obtain and verify the information provided and identity of all beneficial owners.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING OR CHANGING AN ACCOUNT

It is the policy of Citizens Bank of the South (CBOTS) to take all reasonable and appropriate steps to prevent persons engaged in money laundering, fraud, or other financial crime, including the financing of terrorists or terrorist operations, (hereinafter collectively referred to as “money laundering”) from utilizing the Company’s products and services.
Section 326 of the USA PATRIOT Act requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account or changes an existing account. This federal requirement applies to all new customers and current customers. This information is used to assist the United States government in the fight against the funding of terrorism and money-laundering activities.
What this means to you: when you open an account or change an existing account, we will ask for your name, physical address, mailing 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.

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Signature

Date

Comment

1-877-99-CBOTS / cbots@cbots.com

1-877-99-CBOTS / cbots@cbots.com

Applicant Information

Money Service Business Questionnaire

ACCOUNT INFORMATION

Information About Your Account

Additional Banking Needs

Thank you for your application for a deposit account with Citizens Bank of the South. Your application process is almost complete.

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