Deposit Account Application

Please indicate whether you intend to apply for an individual or joint account. Applicants for joint accounts should complete the applicable secondary account owner sections of the application. You must be a U. S. Citizen with a U.S. address residing within our market area and have a valid Social Security number to apply online.

Applicant Information

Primary Account Owner

First Name*

Last Name*

Suffix

Date of Birth*

Present Street Address* Please do not enter a P.O. Box unless you are currently serving in the military.

City*

State*

Zip Code*

Number of Years at this address:

Total Years*

Total Months

Own/Rent*

Phone Number:*

Home Phone Number

Cellphone Number

Best time to call*

Preferred method of contact*

Email address*

Social Security Number*

Driver's License Number*

State Issued*

Date Issued*

Date of Expiration*

Secondary Owner (for Joint Account)

First Name*

Last Name*

Suffix

Date of Birth*

Current Address

Same address as Primary Account Owner

Present Street Address* Please do not enter a P.O. Box unless you are currently serving in the military.

City*

State*

Zip Code*

Number of Years at this address:

Total Years*

Total Months

Own/Rent*

Phone Nunber:*

Home Phone Number

Cellphone Number

Best time to call*

Preferred method of contact*

Email address*

Social Security Number*

Driver's License Number*

State Issued*

Date Issued*

Date of Expiration*

Account Information

For information on BSNB’s products and services, click any of the following links.

ACH Funding Amount of Initial Deposit(s):*

Checking

Savings/Money Market

Certificate of Deposit

Total Initial Deposit(s)

Bank Routing and Account Number BSNB is authorized to initiate a transfer from to open new deposit account(s):

Routing Number*

Account Number*

Account Type

ACH Funding Authorization: (I/We authorize BSNB to initiate an ACH charge for the total initial deposit amount from the bank routing and deposit account number shown above. If the funding account is with BSNB, an internal transfer is authorized.)

Select additional services to apply for:

ATM/Debit Card (If desired, cards can be restricted for ATM use only. Please inform the bank representative of your preference during the initial call.) Learn More »

Savings Overdraft Transfer (Automatically transferring funds from a savings account to prevent overdrawing your checking account.) Learn More »

After submitting this application a BSNB employee will call you within one business day to confirm the information contained in this application. During this call you’ll be asked to arrange a convenient time to visit a branch location of your choice to sign signature cards, provide proof of identity, order checks and/or ATM Debit Cards and/or complete the savings overdraft transfer documentation. Account signature card(s) are available for signing within three business days of application.

If you have any questions, please contact us at (518) 885-6781, or through our online guestbook. Thank you for choosing BSNB.

Disclosure

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 to you: When you open an account, or apply for a loan, we will ask 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 identifying documents.

Please note, this application is subject to verification and approval. In order for us to process your application correctly, we will contact the primary account owner by telephone to verify the information provided and may request additional documentation. When you submit this application, you also agree that this Institution reserves the right to review your eligibility through an authorized third party service provider.

By typing in the owner's name and clicking the submit button below, I(we) hereby certify that everything stated above is correct.

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New Customer Account Application

Applicant Information

Primary Account Owner

Secondary Owner (for Joint Account)

Account Information

Disclosure

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