1 Contact Info 2 Account Information 3 Applicant Information 4 Co - Applicant Information 5 Signers 6 Privacy Policy How can we contact you? Let's start with a little information about you. First Name * Required Middle Name Required Last Name * Required Email Address * Required Confirm Email Address * Required Address Line 1 * Required Address Line 2 City * Required State * Required Please select a state Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Northern Mariana Islands Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington U.S. Virgin Islands West Virginia Wisconsin Wyoming Zip * Required Date of Birth *Invalid Date Social Security Number *Required Phone Number *Required Account Information Alliance Bank currently has locations in WI and provides service in some areas of MN. If you do not live or plan to live in these areas, we are unable to process your online application. I confirm that I currently reside in the state of Wisconsin or Minnesota * Required Select Yes Which branch location do you or would you frequent the most? * Required Select Mondovi Osseo Cochrane Bluff Siding Will this be an individual or a joint account? Required Select Individual Joint Type of Checking account(s) you are applying for: Required Select Worry Free Flex Checking Regular Checking HSA Checking NOW Super NOW Money Market Undecided Additional Checking account(s) you are applying for: Required Select Worry Free Flex Checking Regular Checking HSA Checking NOW Super NOW Money Market None Type of Savings account(s) you are applying for: Required Select Statement Savings Christmas Club Vacation Club Child Savings Undecided Type of Savings account(s) you are applying for: Required Select Statement Savings Christmas Club Vacation Club Child Savings None What is the intended purpose for opening this account(s)? * Required Select For general banking purposes I am new to the area To establish a savings I need an account for Direct Deposit Bringing my accounts from another bank Other If Other please describe * Required Applicant Information Please answer all the questions. When is the best time to contact you? Required Select Morning Afternoon Either Preferred method of contact Required Select Email Phone Either Driver’s License # Required Driver’s License Issue Date Required Driver's License Expiration Date Required Birth City Required Mother’s Maiden Name Required Current Employer Company Name Required Work Phone Number Required Company Address Required Company State Required Select AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Company Zip Required Are you a senior political figure within a country other than the United States or are you a close friend, spouse or immediate family member to a senior political figure within a country other than the US? * Required Select Yes No If yes, please specify the country and the name of the territory office, representatives, name politician, and title of office held * Required Co - Applicant Information Please answer all the questions. When is the best time to contact you? Required Select Morning Afternoon Either Preferred method of contact Required Select Email Phone Either Birth City Required Driver’s License # Required Driver’s License Issue Date Required Driver’s License Expiration Date Required Mother’s Maiden Name Required Current Employer Company Name Required Work Phone # Required Company Address Required Company State Required Select AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Company Zip Required Are you a senior political figure within a country other than the United States or are you a close friend, spouse or immediate family member to a senior political figure within a country other than the US? Required Select Yes No If yes, please specify the country and the name of the territory office, representatives, name politician, and title of office held. * Required Additional Signers Create and assign signers for signature roles. Add Signer Signer * Required Select a signer None/Not Applicable Signer * Required Select a signer None/Not Applicable All Signers Privacy Policy Please read and accept the privacy policy to continue. Accept Privacy Policy You're done! Thank you for completing your application! You can now begin signing your closing documents. Thank you for completing your application!Your financial institution is reviewing your application and will contact you for the next steps.You can now safely close your browser window or tab. Thank you for your submission! Your financial institution will contact you for the next steps.You can now safely close your browser window or tab. © Copyright 2024 Epic River Financial, Inc. All rights reserved. Version 24.1.3.13