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Customer Application
 
Please complete the information below and a Farmers State Bank representative will contact you with in 48 hours.
 
PRIMARY APPLICANT INFORMATION
 
New Customer         Existing Customer:
 
Type of Account:
 
First Name: Home Phone #
MI: Cell Phone #
Last Name: Email Address:
Address: Date of Birth:
City: City of Birth:
State: Employer:
Zip Business Phone #:
Mothers Maiden Name:    
 
 
SECONDARY APPLICANT INFORMATION (If Applicable)
 
Joint         Authorized Signer           Custodian          P.O.A.         P.OD.            
 
First Name: Home Phone #
MI: Cell Phone #
Last Name: Email Address:
Address: Date of Birth:
City: City of Birth:
State: Employer:
Zip Business Phone #:
Mothers Maiden Name:    
   
What number should we use to contact you?
What time of the day is best to contact you?
   
Are you interested in other FSB Accounts? Yes         No
 
        

 
 
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Bank Locations in Cedar Falls, Waterloo, Jesup, Raymond, Dunkerton

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