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Apply Now - Checking

* = Required Field

Ownership (select one):
Personal: Please Select Single Owner (Individual) Joint - With Right To Survivorship Joint - No Survivorship Payable On Death	Business: Please Select Sole Proprietorship Partnership Corporation LLC
Type Of Account:*	Please Select Reward Checking Standard Checking Basic Checking NOW Account Mainstreet Checking Mainstreet 50 Campus Checking Solid Gold Club Checking Bankers Choice Business Standard Checking Business NOW Account
Branch Location: *       Please Select Main – 623 W. Main St., Lebanon Baddour – 1444 Baddour Pkwy. W., Lebanon TN Blvd – 200 Tennessee Blvd., Lebanon Wal-Mart – 615 S. Cumberland, Lebanon Castle Heights – 1130 Castle Heights Ave. N., Lebanon Leeville/109 – 440 Hwy. 109 N., Lebanon Watertown – 101 Public Square, Watertown Gladeville – 8875 Stewarts Ferry Pike, Gladeville Mt. Juliet – 1476 N Mount Juliet Road, Mt. Juliet Hwy 70 – 11835 Lebanon Road, Mt. Juliet Providence – 709 S. Mt. Juliet Road, Mt. Juliet Hermitage – 4736 Andrew Jackson Pkwy., Hermitage Donelson – 217 Donelson Pike, Nashville Trousdale – 127 McMurry Blvd., Hartsville Memorial Blvd – 3110 Memorial Blvd., Murfreesboro Broad St. – 710 NW Broad St., Murfreesboro Church St – 2640 S Church St, Murfreesboro Smyrna – 210 Commerce Dr., Smyrna Smithville – 576 W Broad St., Smithville Alexandria – 306 Brush Creek Road, Alexandria Carthage – 1300 Main St. N., Carthage Gordonsville – 7 New Middleton Hwy., Gordonsville Gallatin – 455 West Main St., Gallatin Hendersonville – 175 East Main St., Hendersonville
PRIMARY ACCOUNT HOLDER
Last Name*: First Name*: Middle Name:
Social Security Number*:
Business Name: (if you selected a business account)
Employer Identification Number: (for businesses)
Current Address*:
City*:
State:	TN
Zip Code*:
How Long (Years):
Home Phone*:
Work Phone:
Email Address:
Date Of Birth*:
Drivers License Number*:	St:
US Citizen?:	Yes No
Employed By :
Address:
City:
State:
Zip Code :
SECONDARY ACCOUNT HOLDER
Last Name: First Name: Middle Name:
Social Security Number:
Relationship to Account Holder:
Business Name: (if you selected a business account)
Employer Identification Number: (for businesses)
Current Address:
City:
State:	TN
Zip Code:
How Long (Years):
Home Phone:
Work Phone:
Email Address:
Date Of Birth:
Drivers License Number:	St:
US Citizen?:	Yes No
Employed By:
Address:
City:
State:
Zip Code :
PAYABLE ON DEATH BENEFICIARY (If you selected POD Ownership)
Last Name: First Name: Middle Name:
Social Security Number:
Relationship to Account Holder:
Home Phone:
Current Address:
City:
State:
Zip Code:
Date Of Birth:
SIGNERS ON ACCOUNT (if you selected business account)
Signer #1
Last Name: First Name: Middle Name:
Social Security Number:
Home Phone:
Current Address:
City:
State:	TN
Zip Code :
Date Of Birth:
Signer #2
Last Name: First Name: Middle Name:
Social Security Number:
Home Phone:
Current Address:
City:
State:	TN
Zip Code :
Date Of Birth:
DEPOSIT INFORMATION
Initial Deposit*:
Initial Deposit Type:	Please Select Cash Check Other (Please Specify Below)
If Other, Please Specify:
ANTICIPATED ACTIVITY The following information will assist us in suggesting products and services for your specific needs.
Anticipated weekly cash withdrawals:	$
Anticipated weekly cash deposits:	$
Do you anticipate conducting or receiving wire transfers?	Yes No
How often?
Do you anticipate purchasing cashier's checks?	Yes No
How often?
Do you anticipate sending or receiving regular ACH transactions?	Yes No
How often?
I understand that this is an application for an account with Wilson Bank & Trust, and that the approval process may include an inquiry into my past banking relationships and/or a review of my credit history.
Retype the code from the picture   Code:

DeKalb Community Bank, Community Bank of Smith County and Trousdale Bank & Trust are offices of Wilson Bank & Trust, Lebanon, Tenn.