IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT

To help the government fight the funding of terrorism and money laundering activites, federal law requires all financial institutions to obtain, verify and record information that on personal accounts identifies each person who opens an account. In addition, on legal entity accounts, we will require identification on beneficial owners and the controlling person.

What this means for you: When you open an account, we will ask for your name, physical 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 complete the following form

A Customer Service Representative will reach out to you by phone to complete the account opening process.  Additional information will be required to properly verify your identity.  If you have any questions please call Branch Administrator, Danielle Honn at 217-452-3041

PERSONAL INFORMATION:

Primary Owner

Required
Required
Required
Required
Required
Required
Required

Joint Owner (if applicable)

CONTACT INFORMATION:

Primary Owner

Joint Owner (if applicable)

IDENTIFICATION:

Primary Owner

Joint Owner (if applicable)

ACCOUNT TYPES:

Find the Checking and/or Savings account that best fits your needs!

Select Account Type:

FUNDING ACCOUNT:

PLEASE CHOOSE ONE OPTION:

FINAL STEP:

Please read and put a check mark in the following consent boxes to finalize your submission.

Required

Subsequent use of your information will be in accordance with our privacy notice, which will be emailed to you as part of the application process. Petefish, Skiles & Co. Bank may also use this information to contact you by means of phone call, email, or text message to assist with the completion of the application process. PS&Co. will also email you other relevant documents and disclosures for your review during and after the application process.

Required

By checking this box, if my application is approved, I sign and agree to authorize Petefish, Skiles & Co. Bank to immediately initiate a one-time ACH (or other) debit transaction from the deposit account listed above in the amount specified for the credit to the "Deposit Account" held at Petefish, Skiles & Co. Bank. I certify that I authorize to make a debit transaction from the deposit account. I acknowledge that the origination of ACH transactions to my deposit account must comply with provisions of U.S. Law.

Required

I herby certify that all information provided within this application is true and correct to the best of my knowledge.