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Certificates of Deposit Term - Select One |
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24 month-Bump Up CD-If our rate goes up, you can bump up the rate one-time without extending the maturity date.
Not available for IRAs. Please note-We currently offer new accounts to
Central Ohio area residents-the market areas we serve around our
offices.
Unlock our safe to win a prize! |
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Amount of Deposit |
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$
All Internet CDs have a $5,000 minimum. We reserve the right
to limit the amount of funds accepted. We are currently limiting the amount at
$100,000 per household/business.
Please read the account disclosure information. |
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How You Found Us |
We always appreciate any feedback on how you
found our site and any comments about the site as well.
If
"Other", please give details |
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Type of Ownership |
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Before completing your application, please click
here to view our identity verification procedures.
*A copy of your corporate resolution or partnership agreement must
accompany all applications.
**For Trust Accounts: A copy of your Trust Agreement must accompany all applications.
***For Individual Retirement Accounts (IRA): We will send you any additional
forms necessary after your account is opened.
****Custodial: Fill out portion below |
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Beneficiary's Name: |
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| Social Security Number: |
-- |
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Date of Birth: |
// |
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mm/dd/yyyy |
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Complete For Personal Accounts |
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(1) Primary Account Holder
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| Prefix: |
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| First Name: |
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| Middle Initial: |
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| Last
Name: |
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Date
of Birth:
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/ |
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mm/dd/yyyy |
| Social
Security Number: |
-- |
| Street
Address |
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| City: |
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| State: |
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| Zip: |
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| Home
Phone: |
()- |
| E-Mail
Address: |
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| Employer
Name/Address: |
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| Work
Phone: |
() |
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(2) Joint Account Holder (if any) |
| Prefix: |
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| First
Name: |
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| Middle
Initial: |
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| Last
Name: |
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Date
of Birth:
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/ |
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| Social
Security Number: |
-- |
| Street
Address |
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| City: |
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| State: |
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| Zip: |
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| Home
Phone: |
()- |
| E-Mail
Address: |
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| Employer
Name/Address: |
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| Work
Phone: |
() |
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| Signature (1): |
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| Date: |
//mm/dd/yyyy |
| Signature (2) if any: |
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| Date: |
//mm/dd/yyyy |
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If account is joint, both owners must sign.
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Beneficiary's Name: |
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| Social Security Number: |
-- |
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Date of Birth: |
// |
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mm/dd/yyyy |
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*Complete For Non-Personal and Trust Accounts |
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Account Title: |
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Date
of Birth:
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// |
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mm/dd/yyyy |
| TAX
ID Number: |
- |
| Street Address |
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| City: |
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| State: |
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| Zip: |
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| Phone: |
()- |
| FAX: |
()- |
| E-Mail Address: |
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| Company Website: |
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| Number of signatures required for withdrawals: |
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For trusts or corporate or partnership accounts, please complete the following for all
authorized account signers.
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| Signer/Trustee
name and title (1): |
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| Signature
of (1): |
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| Date: |
//mm/dd/yyyy |
| Signer/Trustee
name and title (2): |
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| Signature
of (2): |
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| Date: |
//mm/dd/yyyy |
| Signer
Trustee name and title (3): |
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| Signature
of (3): |
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| Date: |
//mm/dd/yyyy |
| Signer/Trustee
name and title (4): |
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| Signature
of (4): |
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| Date: |
//mm/dd/yyyy |
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W-9 Certification: Under penalties of perjury, I certify
that (1) the tax ID on this form is my correct taxpayer identification number,
and (2) 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 failure to
report all interest and dividends, or because the Internal Revenue Service has
notified me that I am no longer subject to backup withholding.
Upon completion of the application form, please print it
out, sign where appropriate, attach a check made payable to First Community
Bank and a copy of all signer's valid driver's license, include any
other pertinent documents, and then mail in its entirety to:
First Community Bank
Attn.: Dee Kates
4300 E. Broad Street
Columbus, OH 43213
Interest will begin to accrue on your First Community Bank
account when all paperwork is properly completed (including your signature),
the account is processed, and the account is properly funded. If the CD is
accepted, CDs
will be issued and mailed upon receipt of funds.
You can wire the funds to us, however, the appropriate
paperwork must immediately follow. We are on-line with the Federal Reserve.
Please call us beforehand to verify the current offer. Instruct your bank to wire transfer the amount you wish to invest plus a
$15
incoming wire fee to:
First Community Bank, Whitehall, Ohio
ABA Routing and Transit # 0440-1145-3
For The Benefit Of (your name)
This account will automatically renew at maturity. You will
have 10 calendar days after the maturity date to withdraw funds without
penalty. If you prevent renewal, interest will not accrue after final
maturity. A penalty may be imposed for early withdrawal from all CDs.
The Bank reserves the right to verify the above information. Funds must
be in US dollars and is only available to those residing in the U.S.
**All Annual Percentage Yields assume reinvestment of interest and principal.
By signing and returning this form, you have read, understand and agree to all terms
and conditions of this account and all applicable rules and regulations
adopted by First Community Bank. You may request these documents before
opening your account(s), or verify current offers by calling 1-614-239-4600 during regular business hours.
If you have questions, you may call us at one of the numbers above, e-mail
us at info@firstcommunitybank.com
or send your message or special instructions below with your completed
application. We look forward to serving you.
Please type in any additional details or comments below.
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for bank use only:
Term: ______________ APY: ________________
Amount: ____________ Acct.#: ______________
Open date: __________ CSR by: _____________
Date Rec'd: __________ Postmarked:__________ |
