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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
Money Market Checking
Money Market Savings
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| We are / I am applying for: |
| SECTION A - General Information |
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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):*
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Fax:
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| Date of Birth:* |
Social Security Number:* |
Employer:* |
Employer Address: |
| City: |
State: |
Zip Code: |
| Employer Telephone: |
Years There: |
Position / Title:
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Previous Employer (if less than 2 years at current employment): |
Previous Employer Address:
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| City: |
State: |
Zip Code: |
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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): |
| Applicant: |
| I do not wish to furnish this information |
| Ethnicity: |
Sex: |
Race: |
Co-Applicant:
NOTE: Please complete the below requested information only if your loan application is for a home improvement purchase or refinance of a residential dwelling (i.e. 1-4 family home condos, mobile homes or multi-family units/buildings) |
| I do not wish to furnish this information |
| Ethnicity: |
Sex: |
Race: |
| 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. |
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