Personal Account Application

Welcome to Kitsap Bank's Personal Account Application. To open a new account, complete this form and click “Submit”. By clicking “Submit”, you indicate that you intend to open an account with Kitsap Bank. A Kitsap Bank representative will contact you shortly. To complete the application process, you will be asked to stop by the Kitsap Bank branch most convenient to you.

At this time, we will only accept applications from individuals residing in the State of Washington.

Account Information

Account Ownership
Account Type	Term, If Applicable
Expected Opening Deposit View Rates for required account minimums.
Kitsap Bank branch most convenient to you (This is the branch where you expect to complete the majority of your banking transactions)

Primary Account Holder Information

Salutation
First Name	Middle Initial
Last Name	Access Word for This Account
Social Security Number
Primary Identification	Number
Issue Date	Expiration Date
Secondary Identification	Expiration Date
If using a credit card, what type?	If using a credit card, provide issuer
If using a Student or Company ID card, please name the company or school
Date of Birth
Primary Phone Number
Secondary Phone Number
Mailing Address
City	State	Zip Code
Physical Address
City	State	Zip Code
Length of Time at Address
Employer	Occupation
Work Address
City	State	Zip Code
Email Address

Secondary Account Holder Information

Salutation
First Name	Middle Initial
Last Name	Access Word for This Account
Social Security Number
Primary Identification	Number
Issue Date	Expiration Date
Secondary Identification	Expiration Date
If using a credit card, what type?	If using a credit card, provide issuer
If using a Student or Company ID card, please name the company or school
Date of Birth
Primary Phone Number
Secondary Phone Number
Mailing Address
City	State	Zip Code
Physical Address
City	State	Zip Code
Length of Time at Address
Employer	Occupation
Work Address
City	State	Zip Code
Email Address

Would you like a Kitsap Bank Visa debit card with this account?YesNo

Would you like to order Kitsap Bank checks?YesNo

If soSingleDuplicate

Are you interested in enrolling for Online Banking?YesNo

Find out more information about Online Banking.

Do you intend to use Direct Deposit?YesNo

I would like more information about:

Mortgage Loans	Home Equity Loans	Builder Financing
All-In-One Construction Loans	Consumer Loans	SBA Loans
Commercial Loans	Online Bill Pay	Online Banking
Health Savings Accounts	Deposit Connect

Comments

USA Patriot Act Notice: To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. Your name, address, date of birth and other information collected in this application will allow us to identify you. We may also ask for your driver’s license or other identifying documents.

By submitting this application, the applicant and any co-applicant (each referred to as “I”, “my”, and “me”) each represent that all the information in this application is true and correct. I authorize you to obtain any information about me that you believe is necessary to evaluate this application, including consumer reports from consumer reporting agencies. I agree to accept the terms of this account which will be mailed to me upon receipt of this application.

Privacy Statement Fee Schedule Terms and Conditions

Print and retain this form for your records. Rates are subject to change prior to completing the account opening process. As a reminder, you will be contacted by a Kitsap Bank representative. To complete the application process, you will be asked to stop by the Kitsap Bank branch most convenient to you. Two pieces of identification will be required for each account holder.

Thank you for applying for a personal account with Kitsap Bank. We look forward to serving you! If you have any questions, please contact our Customer Service Center at 800-283-5537.