Make the Switch

Moving from one bank
to another can be
intimidating. That's
why we have a simple,
step-by-step Switch
Kit!

Deposit Application


IMPORTANT NOTICE: At this time, we can only accept online applications from the following Tennessee counties: Campbell, Claiborne, Anderson, & Scott counties. If you live outside of these counties, please contact one of our Customer Service Representatives by calling toll free (888) 308-4FNB.

Ownership
Single Owner (individual)
Joint (right to survivorship)
Joint (no right to survivorship)
Primary Account Owner
Name (First, Middle, Last):
Mothers Maiden Name:
Date of Birth (mm/dd/yyyy):
Social Security Number:
Address:
City, State Zip-Plus4: , +
Home Phone Number:
Work Phone Number:
Name of Employer:
Opening Deposit Amt:
Type of Account desired:
Drivers License Number:
Drivers License State:
E-mail Address:
ATM  

Click Here to apply for MasterMoney CheckCard

Joint Account Owner (if you selected joint account ownership)
Name (First, Middle, Last):
Date of Birth (mm/dd/yyyy):
Social Security Number:
Address:
City, State Zip-Plus4: , +
Home Phone Number: ( ) -
Work Phone Number: ( ) -
Name of Employer:
Drivers License Number:
Drivers License State:
E-mail Address:

Click Here to order a MasterMoney CheckCard Application for the joint account holder

Payable on Death Beneficiary (if you selected POD ownership)
Name (First, Middle, Last):
Social Security Number:
Phone Number: ( ) -
Address:
City, State Zip-Plus4: , +
Additional Beneficiary:
Name (First, Middle, Last):
Social Security Number:
Phone Number: ( ) -
Address:
City, State Zip-Plus4: , +
Additional Beneficiary:
Name (First, Middle, Last):
Social Security Number:
Phone Number: ( ) -
Address:
City, State Zip-Plus4: , +
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 FIRST NATIONAL BANK OF LAFOLLETTE TENNESSEE 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 DEPOSIT AGREEMENT. I FURTHER AGREE TO RETURN ANY ACCESS DEVICE FOR OBTAINING FUNDS FROM ANY TYPE OF ACCOUNT UPON DEMAND BY FIRST NATIONAL BANK OF LAFOLLETTE.

I HAVE READ THE ABOVE STATEMENT AND AGREE TO THE TERMS SET OUT THEREIN.