* indicates a required field


Select your office

Springville
Provo
Spanish Fork
Riverside Plaza
Mapleton
Payson
Orem
American Fork
Lehi
Pleasant Grove



Ownership

Single Owner (individual)
Joint (right to survivorship)
Joint (no right to survivorship)
Payable on Death (POD)



Primary Account Owner

*Name (First M. Last):
*Date of Birth (mm/dd/yyyy):
*Social Security Number:
*Address:
*City, State Zip: ,
*Home Phone Number:
Work Phone Number:
Cell Phone Number:
*Driver's License Number: State:
*E-mail:
*Mother's Maiden Name:



Joint Account Owner (if you selected joint account ownership)

*Name (First M. Last):
*Date of Birth (mm/dd/yyyy):
*Social Security Number:
*Address:
*City, State Zip: ,
*Home Phone Number:
Work Phone Number:
Cell Phone Number:
*Driver's License Number: State:
*E-mail:
*Mother's Maiden Name:



Payable on Death Beneficiary (if you selected POD ownership)

*Name (First M. Last):
*Social Security Number:
*Address:
*City, State Zip: ,
*Home Phone Number:



Deposit Information

*Initial Deposit:
Initial Deposit Type:
If transfering from another Central Bank account...
Account Number

Rates and Interest Information
Please select what term you would like from the following table:
Account/Term Interest Rate APY*
Automatically renewable
Interest will be credited .
Interest options:
    Add interest to CD.
    Credit interest to my account # .



A minimum deposit of $500.00 is required to open any Certificate of Deposit. If you withdraw any of the principal before the maturity date we may impose a penalty. If the maturity is one year or less, but at least 32 days, you must forfeit the equivalent of one month interest on the amount withdrawn calculated at the nominal rate being paid on the certificate. If the maturity is more than one year, you must forfeit the equivalent of three months interest on the amount withdrawn calculated at the nominal rate being paid on the certificate. If the account is closed before interest is credited, you will not receive the accrued interest. The annual percentage yield assumes interest compounds quarterly and will remain on deposit until maturity. A withdrawal will reduce earnings. This account will automatically renew. You will have 10 days after the maturity date to withdraw funds without penalty.


Taxpayer Identification Number Certification

The Social Security Number shown above is my correct Social Security Number.

I am not subject to backup withholding either because I have not been notified that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding.

I am an exempt recipient under the Internal Revenue Service Regulations.

I am not a United States person, or if I am an individual, I am neither a citizen nor a resident of the United States.

I certify under penalties of perjury the statements checked in this section are true.

I authorize to obtain a copy of my current credit report as a condition of acceptance of this application and for the purpose of extension of or renewal of credit.

I would like to access this account through Online Banking.

* indicates a required field