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Deposit Account Application

To Apply, having already read and accepted account disclosures, simply complete and submit application. South Carolina Community Bank, upon approval, will send to you a new account packet. After executing the enclosed documents as indicated, return to us to activate your account.

A representative from South Carolina Community Bank may contact you to verify your account application. Feel free to contact us with any questions you may have.

If you work in South Carolina and reside outside of South Carolina please contact us.

* = Required Field

I am applying for:
(check all that apply)		 DEPOSIT ACCOUNTS
Free Checking
Individual Retirement Account
Interest Checking
Regular Checking
Senior Gold Checking
Holiday Savings/Christmas Club
Minor Savings
We are / I am applying for: 
SECTION A - General Information

First Name:*

 Middle Name:* Last Name:*

Email (yourname@domain.com):*
Street Address*: City:* State:* Zip Code:*
Mailing Address: City: State: Zip Code:
Previous Home Address: City: State: Zip Code:

Home Phone (please include area code):*
 Fax:
Date of Birth:*
Social Security Number:*

Employer:*
Employer Address:
City: State:
Zip Code:
Employer Telephone:

Years There:


Position / Title:

Previous Employer (if less than 2 years at current employment):
Previous Employer Address:
City: State:
Zip Code:
Please Provide The Following Verification Information:
Name of Current Bank: Address of Bank:
City:
State:

Zip Code:


Account Number :
SC Drivers License or State Issue ID Number:* Are you a US Citizen?
Yes
No
Nearest Relative Not Living With You: Address:
City:
State: Zip Code:
Phone Number (including area code):
Mother's Maiden Name (for security purposes):
BY CLICKING ON THE SUBMIT BUTTON BELOW, I (WE) APPLY FOR THE DEPOSIT PRODUCTS LISTED ABOVE AND CERTIFY THAT ALL INFORMATION PROVIDED ABOVE IS CORRECT AND AUTHORIZE YOU TO CHECK MY (OUR) CREDIT AND VERIFY THE INFORMATION PROVIDED IN THIS APPLICATION. I (WE) ALSO CERTIFY UNDER PENALTY OF PERJURY THAT THE SOCIAL SECURITY NUMBER(S) PROVIDED ABOVE IS/ARE CORRECT AND THAT I AM NOT (WE ARE NOT) SUBJECT TO BACKUP WITHHOLDING UNDER THE INTERNAL REVENUE CODE. I (WE) UNDERSTAND THAT ADDITIONAL INFORMATION MAY BE REQUIRED BEFORE A DECISION CAN BE MADE REGARDING THIS APPLICATION. I (WE) FURTHER UNDERSTAND THAT APPROVAL BY South Carolina Community Bank FOR ANY OF THE LOAN OR DEPOSIT PRODUCTS IS CONDITIONED ON MY (OUR) AGREEMENT TO ABIDE BY ALL TERMS AND CONDITIONS CONTAINED IN THE APPLICABLE LOAN AGREEMENT AND/OR DEPOSIT AGREEMENT. I FURTHER AGREE TO RETURN ANY ACCESS DEVICE FOR OBTAINING FUNDS FROM ANY TYPE OF ACCOUNT UPON DEMAND BY South Carolina Community Bank.
I HAVE READ THE ABOVE STATEMENT AND AGREE TO THE TERMS SET OUT THEREIN.
NO MORE 2PM CUTOFF.  ALL DAY BANKING BEGINNING NOVEMBER 20, 2008.
South Carolina Community Bank
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FDIC

Equal Housing Lender