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First National Bank of Griffin

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Here to assist

Please submit the information below and a First National Bank customer service representative will contact you by the end of the next business day.

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Account Type

Choose the account type you are interested in:

Choose Account Type: *

Ownership

Ownership

Single Owner (Individual)

Joint (right to survivorship)

Joint (no right to survivorship)

Payable on Death (POD)

Primary Account Owner

Name (First M. Last) *

Date of Birth (mm/dd/yyyy) *

SSN *

Address (no P.O. Box) *

City*

State*

Zip*

Mailling Address (if different than physical address)

City

State

Zip

Home Phone Number *

Employer Name

Self-employed?*

Yes

No

Work Phone Number

Position/Occupation

Driver's License Number *

State

Issue Date

Expiration Date

Email

Joint Account Owner

Name (First M. Last)

Date of Birth (mm/dd/yyyy)

SSN

Employer Name

Self-employed?

Yes

No

Work Phone Number

Position/Occupation

Driver's License Number

State

Issue Date

Expiration Date

Borrower / Co-Borrower Agreement

If this is an application for joint credit, Borrower and Co-Borrower each agree that we intend to apply for joint credit (please check the box below if you agree):

Borrower

Co-Borrower

Payable on Death Beneficiary

(if you selected POD ownership)

Name (First M. Last)

SSN

Phone Number

Address

City

State

Zip

Deposit Information

Initial Deposit*

Initial Deposit Types

Loan Request

Loan Type

Unsecured

Auto

Real Estate (If the Loan Type is Real Estate, you must apply through the Mortgage tab above, or in person at a FNB branch.)

Commercial

Other

Loan Amount Requested?

Loan Purpose?

Have you had any previous loans with First National Bank of Griffin?*

Yes

No

Please provide information on any collateral that you want us to consider when evaluating your application

Taxpayer Identification Number Certification

Social Security Number(s) The Social Security Number(s) shown above is my correct SSN. *

Backup Withholding 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 a failure to report all interest or dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding.

Exempt Recipients I am an exempt recipient under the Internal Revenue Service Regulations.

Nonresident Alien I am not a United States person, or if I am an individual, I am neither a citizen nor a resident of the United States.

I certify under penalties of perjury the statements checked in this section are true. *

I authorize First National Bank of Griffin to obtain a copy of my current credit report as a condition of acceptance of this application and for the purpose of extension of or renewal of credit. *

I would like to access this account through Online Banking.

There was an error submitting the form.

Thank you for your submission!

We will be in touch with you soon.

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Contact FNB

onlineservices@FNBbanking.com

318 S Hill St, Griffin, GA 30224

© First National Bank of Griffin. Member FDIC. Equal Housing Lender. FNB NMLS#: 452582

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