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Primary Account Holder Secondary Account Holder

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Primary Account Holder Secondary Account Holder Powered By Docstoc
					                                               THE FAUQUIER BANK
                                          PERSONAL ACCOUNT APPLICATION

                                 Working together to make each client’s financial life easier


Please print and complete the information below:



Primary Account Holder

First Name              Middle Initial          Last Name                              Social Security Number


Street Address                                                                         Birth Date


City                    State             ZIP                                          Home Phone


Mailing Address (if different from Street Address)                                     Driver’s License Number Issuing State


City (if different from Street Address)    State        Zip                            Issue Date          Expiration Date

_____________________________________________________________________
E-mail Address


Employer                                    Occupation                                 Work Phone


Mother’s Maiden Name                                               Would you like a debit card?          Yes        No




Secondary Account Holder

First Name              Middle Initial          Last Name                              Social Security Number


Street Address                                                                         Birth Date


City                    State             ZIP Code                                     Home Phone


Mailing Address (if different from Street Address)                                     Driver’s License Number


City (if different from Street Address)    State        ZIP Code                       State Issued        Expiration Date

_____________________________________________________________________
E-mail Address


Employer                                    Occupation                                 Work Phone


Mother’s Maiden Name                                               Would you like a debit card?          Yes        No
                                                                                                                Revised 11/20/2008
Pay Yourself First
Saving money has never been easier. We’re offering a simple and convenient way to make
monthly deposits automatically from your checking account into a savings account. You can
use your existing Fauquier Bank account, or open a new one today.

By authorizing a monthly transfer from your checking account into your savings
account, you can increase your savings account balance effortlessly. You will be
amazed how quickly your savings will grow.

Doesn’t it make sense to pay yourself before paying everyone else?


Name ________________________________________________________________


1. Do you have a TFB checking account to transfer from?

             Yes              No       ___________________________________
                                        TFB Checking Account Number

2. Do you have a TFB savings account to transfer to?

             Yes              No       __________________________________
                                        TFB Savings Account Number

3. How much do you want to pay yourself each month? $


4. What day of the month do you want to pay yourself? *


5. What month would you like to start paying yourself first?




Signature:                                                   Date:



Signature:                                                   Date:


*The current day’s available balance is used to determine if the transfer is possible.



                                                                                         Revised 11/20/2008
Marketing Questionnaire
1)   Are you already a Fauquier Bank customer?
        Yes
        No


2)   How did you first become aware of Fauquier Bank’s new checking accounts?
       Received a letter in the mail
       A Fauquier Bank employee told me
       Saw a banner on the building
       A friend told me
       Saw an advertisement on TV or radio or in a newspaper
       Other (please specify) __________________________________


3)   Do you currently have more than one personal checking account?
        No
        Yes, I have two
        Yes, I have three
        Yes, I have four or more


4)   Why are you moving your checking account? (Please check all that apply.)
       High service charges at other bank
       Fauquier Bank’s lower prices
       Fauquier Bank’s is more convenient for me
       I have other relationships at Fauquier Bank
       Lines too long at former bank
       Rude employee(s) at former bank
       Other (please specify) ___________________________________


5)   Which of the following accounts/services do you currently maintain at Fauquier Bank or at any
     other institution? (Please check all that apply)

        Checking                                                Savings
        Automatic Loan Payment                                  Brokerage/Investment Services
        Certificate of Deposit                                  Home Equity Loan
        Mortgage Loan                                           Car Loan
        Home Equity Line of Credit                              Home Improvement Loan
        IRA (Individual Retirement Account)                     MasterCard/VISA Credit Card
        ATM Card                                                Business Services
        Check Card                                              Online Banking
        Direct Deposit                                          Telephone Banking




                                                                                   Revised 11/20/2008
Marketing Questionnaire
6)    Will you sell Fauquier Bank your unused checks?
          Yes, I brought them with me
          Yes, I plan on bringing them with me on my next visit
          No, I plan on keeping both checking accounts

7)    How likely are you to recommend a Fauquier Bank checking account to a friend?
        Very likely
        Not at all likely

8)    How important are each of the following to your decision to open a checking account today?

                                    Very Important     Somewhat Important        Not a Factor
      Buy unused checks?
      Free checking?
      Free gift?


9)    I would like more information on the following services. (Please check all that apply)
          Checking                                                 Savings
          Automatic Loan Payment                                   Brokerage/Investment Services
          Certificate of Deposit                                   Home Equity Loan
          Mortgage Loan                                            Car Loan
          Home Equity Line of Credit                               Home Improvement Loan
          IRA (Individual Retirement Account)                      MasterCard/VISA Credit Card
          ATM Card                                                 Business Services
          Check Card                                               Online Banking
          Direct Deposit                                           Telephone Banking

10)   My age is                                              11)   I am
         Under 21                                                      Single
         35 – 49                                                       Married
         21 - 34
         35 - 49
         50 - 64
         65+

12)   My combined annual household income is
         Under $25,000                                       13)   I own my home
         $25,000 - $34,999                                             Yes
         $35,000 - $49,999                                             No
         $50,000 or more

14)   I live _____ miles from this banking center
           Less than 1
           1–3
           4 or more



                                                                                     Revised 11/20/2008

				
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