Personal Banking Application Leave me blank for Personal Banking Application. Are you a current Sugar River Bank Customer? Yes NoApply for a New: Checking AccountSelect Checking Account Type IndividualJoint Savings AccountSelect Savings Account Type IndividualJointAccount InformationChecking Account SRB Premium Checking Deposit Plus Checking Golden Club Checking Free Checking** All rates subject to change without notice. Please verify rates by contacting your nearest branch office. Please note other terms, conditions, or restrictions may apply depending upon product offer.Account InformationSavings Account Statement Savings Money Market Fund Saver (Youth Savings Account)** All rates subject to change without notice. Please verify rates by contacting your nearest branch office. Please note other terms, conditions, or restrictions may apply depending upon product offer.Applicant InformationFirst Name * Middle Initial Last Name * Permanent Address * (No P.O. Boxes) City * State Zip How long at this address?Years: Months: Have you lived at current address less than 2 years? Yes NoPrevious Address City (Previous Address) State (Previous Address) Zip (Previous Address) Home Phone * Work Phone * Employer * Social Security # * Date of Birth * Driver's License Number * State of Driver's License * Email Address * Online Banking Information Please give me access to and the ability to transfer funds between ALL acounts on which I am an owner. Please give me access to and the ability to transfer funds between ONLY the following listed accounts which I am an owner.Account NumberFirst Account Number Descriptive NameFirst Account Descriptive Name Second Account Number Second Account Descriptive Name Third Account Number Third Account Descriptive Name Fourth Account Number Fourth Account Descriptive Name Fifth Account Number Fifth Account Descriptive Name Sixth Account Number Sixth Account Descriptive Name Seventh Account Number Seventh Account Descriptive Name Eighth Account Number Eighth Account Descriptive Name Co-Applicant InformationFirst Name * (Co-Applicant) Middle Initial (Co-Applicant) Last Name * (Co-Applicant) Permanent Address * (No P.O. Boxes) (Co-Applicant) City * (Co-Applicant) State (Co-Applicant) Zip (Co-Applicant) How long at this address?Years: (Co-Applicant) Months: (Co-Applicant) Have you lived at current address less than 2 years? Yes (Co-Applicant has been at this address less than 2 years) No (Co-Applicant has been at this address longer than 2 years)Previous Address (Co-Applicant) City (Previous Address for Co-Applicant) State (Previous Address for Co-Applicant) Zip (Previous Address for Co-Applicant) Home Phone * (Co-Applicant) Work Phone * (Co-Applicant) Employer * (Co-Applicant) Social Security # * (Co-Applicant) Date of Birth * (Co-Applicant) Driver's License Number * (Co-Applicant) State of Driver's License * (Co-Applicant) Email Address * (Co-Applicant) What type of account are you applying for? *Individual Credit: Complete APPLICANT information and sign.Joint Credit w/ spouse or other person living at same address: Applicant & Co-Applicant/Spouse must sign.Joint Credit w/ someone not living at same address: Each of you must complete a separate application as if you were applying for individual credit.Affirmative Attestation: If this is an application for joint credit with another person, complete all sections, providing information in the Principle Information section about the joint applicant.ApplicantInitial * (Applicant) Co-ApplicantInitial (Co-Applicant) Co-Applicant Employment InformationEmployer * Occupation * Gross Monthly Employment Income * Previous Employer (If less than 2 years at present address) Length of Employment *Years: Months: Vehicle Loan InformationYear * Make * Model * How much would you like to borrow? * For how long?Years: Months: When will you need this money? * (mm/dd/yyyy) Applicant Financial ReferencesMortgage Holder Mortgage Balance Monthly Mortgage Payment (including taxes) Current Home Value Landlord Monthly Rent Accounts with Sugar River Bank Accounts with other Financial Institutions Names of other Financial Institutions Loans: List Lender Name(s)Loan #1 Monthly Payment (for loan #1) Loan #2 Monthly Payment (for loan #2) Loan #3 Monthly Payment (for loan #3) Credit Cards: List Credit Cards Below (Issuer Name)Card #1 Monthly Payment (For card #1) Card #2 Monthly Payment (For card #2) Card #3 Monthly Payment (For card #3) Are you required to pay Child Support or Separate Maintenance? * Yes (Required to pay child support or separate maintenance) No (Not required to pay child support or separate maintenance)Monthly Payment (of child support or separate maintenance) Please indicate with an *** any loans or credit card balances listed above that you would like to refinance.Co-Applicant Financial ReferencesMortgage Holder (For co-applicant) Mortgage Balance (For co-applicant) Monthly Mortgage Payment (including taxes) (For co-applicant) Current Home Value (For co-applicant) Landlord (For co-applicant) Monthly Rent (For co-applicant) Accounts with Sugar River Bank (For co-applicant) Accounts with other Financial Institutions (For co-applicant) Names of other Financial Institutions (For co-applicant) Loans: List Lender Name(s)Loan #1 (For co-applicant) Monthly Payment (for loan #1 of co-applicant) Loan #2 (For co-applicant) Monthly Payment (for loan #2 of co-applicant) Loan #3 (For co-applicant) Monthly Payment (for loan #3 of co-applicant) Credit Cards: List Credit Cards Below (Issuer Name)Card #1 (For co-applicant) Monthly Payment (For card #1 of co-applicant) Card #2 (For co-applicant) Monthly Payment (For card #2 of co-applicant) Card #3 (For co-applicant) Monthly Payment (For card #3 of co-applicant) Are you required to pay Child Support or Separate Maintenance? * Yes (Co-applicant is Required to pay child support or separate maintenance) No (Co-applicant is Not required to pay child support or separate maintenance)Monthly Payment (of child support or separate maintenance) Please indicate with an *** any loans or credit card balances listed above that you would like to refinance.Application Completion InformationChoose the location you would like to complete your application Newport, Main OfficeConcord BranchGrantham BranchNew London BranchSunapee BranchWarner BranchHow would you prefer to be contacted? Phone Email MailWhat is the best time to arrange an appointment? Morning Lunchtime AfternoonSubmitThere was an error submitting the form Thank you! Someone will be in touch with you soon.
