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North Brookfield Savings Bank
Account Holders must reside in State of Massachusetts.
Important Information about Procedures for Opening a New Account
Identification Procedures Requirements: 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.
this means for 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
You should ONLY fill out this Application on-line if you are
using a browser with the latest security enhancements. If you don't
have the latest version, download a copy now.
1. Complete Application and click "Submit Application" or fax it to 508-867-7574.
2. To safeguard your privacy, QUIT your browser and restart it again
after using this form. This form is NOT saved in your computer's memory
when you quit your browser.
3. We will contact you with the location of our closest office for you
to sign a signature card. You may also be requested to provide
photocopies of your Social Security card and Driver's License, or other
|By submitting this application,
I (each person jointly and severally) apply for the account(s) and
Check/ATM card(s) listed above and a personal identification number. As
an account owner, I am subject to all of its bylaws and rules as amended
from time to time. I certify that all information given is correct. I
understand and agree that for all accounts for / or, any one of us opens
in the future is governed by this application, and all persons listed
here will be owners, except as provided as follows: If I wish an account
to have (as applicable) fewer, additional, or different owner(s), a
completed, signed application for the specific account must be submitted
to and accepted by North Brookfield Savings Bank.
agree to the terms and conditions for any accounts or services that I
have now or in the future, and as they change from time to time. I agree
at any time you may request information from others about my credit or
accounts and that you provide to others experience information about me
or my accounts with North Brookfield Savings Bank.
By clicking the Submit Application button below,
I/We AGREE with the above statement