Security Bank Minnesota complies with Section 326 of the USA PATRIOT ACT. This law mandates that we verify certain information about you while processing your account application. You are advised that if you make any false material statement which you do not believe is true with respect to any information on this application, you are guilty of perjury.

Please select today’s date.
Will there be a joint applicant?*
Will there be a joint applicant?
Please select yes or no.
Do you anticipate sending or receiving wire transfers?*
Do you anticipate sending or receiving wire transfers?
Please select yes or no.
Do you anticipate sending or receiving international wires?*
Do you anticipate sending or receiving international wires?
Please select yes or no.
Please enter an amount.
Types of Deposits/Withdrawals typically made (Check all that apply)*
Types of Deposits/Withdrawals typically made (Check all that apply)
Please select an option.
Please enter an amount.

Primary Applicant's Name

Please enter your first name.
Please enter your last name.
Please enter your date of birth.
Please enter a valid 9 digit Social Security Number, either 000000000 or 000-00-0000.

Physical Address (No PO Box)

Please enter your current street address
Please enter your current city.
Please select your current state.
Please enter a 5 digit zip code.
Invalid Input
Please enter your primary phone number.
Please enter your secondary phone number.
Please enter a valid email address.
Please enter your driver’s license number.
Please enter your driver’s State of Issuance.
Please select the correct date.
Please select the correct date.
Are you a US Citizen?*
Are you a US Citizen?
Please select yes or no.
Are you a permanent resident?*
Are you a permanent resident?
Please select yes or no.

Primary Applicant's Employer Information

Are you currently employed?*
Are you currently employed?
Please select an employment status.
Employer name is required.
Job title is required.

Employer Address

Please enter your employer street.
Please enter your employer city.
Please select your previous state.
Please enter your previous employer's zip code.
Invalid Input
Please enter a valid phone number.
Please enter number of years.
Please enter your previous employer name.

Previous Employer Address

Please enter your previous employer's street address.
Please enter your employer's previous city.
Please select your previous state.
Please enter your previous employer's zip code.
Invalid Input
Please enter a valid phone number.
Please enter number of years.

Primary Applicant's Other Information

Please enter the nearest relative’s name.

Relative's Address

Please enter the address.
Please enter the city.
Please select the state.
Please enter the zip code.
Invalid Input
Please enter a valid phone number.
1. Have you had a transaction account at this or another financial intermediary within 12 months before making this application?*
1. Have you had a transaction account at this or another financial intermediary within 12 months before making this application?
Please select yes or no.
Institution name is required
2. Have you had a transaction account closed by this or another financial intermediary without your consent within 12 months before making this application?*
2. Have you had a transaction account closed by this or another financial intermediary without your consent within 12 months before making this application?
Please select yes or no.
Institution name is required
3. Have you been convicted of a criminal offense because of the use of checks or similar items within 24 months of making this application? *
3. Have you been convicted of a criminal offense because of the use of checks or similar items within 24 months of making this application?
Please select yes or no.
Institution name is required
Please let us know if you are interested in learning about our other products and services.
Please let us know if you are interested in learning about our other products and services.
Please select an option.
Certification*
Certification
Invalid Input
Authorization*
Authorization
Invalid Input
Sign Above
Please provide your signature.

Joint Applicant's Information

Please enter your first name.
Please enter your last name.
Please enter the date of birth.
Please enter a valid 9 digit Social Security Number, either 000000000 or 000-00-0000.

Joint Applicant's Address

Please enter the street address.
Please enter the city.
Please select the state.
Please enter the zip code.
Please enter the country.
Please enter a valid phone number.
Please enter a valid phone number.
Please enter a valid email address.
Please enter the driver’s license number.
Please enter your driver’s State of Issuance.
Please enter the issue date.
Please enter the expiration date.
Is the joint applicant a US Citizen?
Is the joint applicant a US Citizen?
Please select yes or no.
Are you a permanent resident?*
Are you a permanent resident?
Please select yes or no.

Joint Applicant Employer Information

Is Joint Applicant Currently Employed?*
Is Joint Applicant Currently Employed?
Please select an employment status.
Please enter the employer name.

Joint Applicant - Employer's Address

Please enter the street address.
Please enter the employer city.
Please select the state.
Please enter the zip code.
Invalid Input
Please enter a valid phone number.
Please enter how long you have been at this job.
Please enter the previous employer name.

Previous Employer Address

Please enter the street address.
Please enter the employer city.
Please select the state.
Please enter the zip code.
Please select the country.
Please enter a valid phone number.
Please enter how long you have been at this job.

Joint Applicant's Other Information

Please enter the nearest relative’s name.

Joint Applicant's Relative Address

Please enter the address.
Please enter the city.
Please select the state.
Please enter the zip code.
Invalid Input
Please enter a valid phone number.
1. Have you had a transaction account at this or another financial intermediary within 12 months before making this application?*
1. Have you had a transaction account at this or another financial intermediary within 12 months before making this application?
Please select yes or no.
Institution name is required
2. Have you had a transaction account closed by this or another financial intermediary without your consent within 12 months before making this application?*
2. Have you had a transaction account closed by this or another financial intermediary without your consent within 12 months before making this application?
Please select yes or no.
Institution name is required
3. Have you been convicted of a criminal offense because of the use of checks or similar items within 24 months of making this application? *
3. Have you been convicted of a criminal offense because of the use of checks or similar items within 24 months of making this application?
Please select yes or no.
Institution name is required
Certification*
Certification
Invalid Input
Authorization*
Authorization
Invalid Input
Sign Above
Invalid Input