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As required by the
USA PATRIOT ACT
Important information about procedures for opening
a new account
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.
What this means for you: When you
open an account, we will ask for your name, address,
date of birth, and other information that will allow
us to identify you.
We may also ask to see your driver's license or
other identifying documents.
Marine Bank & Trust thanks you for
your understanding for joining us in securing a
safer tomorrow.
Please fill out the following information, print off
the form and mail to:
ATTN: New Accounts Department
Marine Bank & Trust
PO Box 190
410 Buchanan St
Carthage, IL 62321
Upon receipt of your application pending approval, we will order you
a Mastermoney Card.
You should receive your new card within (2) two weeks.
I. ACCOUNT HOLDER(S) INFORMATION
Primary Applicant's Information:
(include suffix (Jr., Sr.) if applicable)
Prefix
Mr Mrs Ms
First Name
MI
Last Name
Suffix
Phone
Date of Birth
/
/
Social Security Number/Tax ID Number
Address
City
State
ZIP
E-mail:
This card should be linked to my
Checking Account #
for purchases and ATM use.
Joint Applicant's Information:(if applicable) (include suffix (Jr., Sr.) if applicable)
Prefix
Mr Mrs Ms
First Name
MI
Last Name
Suffix
Phone
Date of Birth
/
/
Social Security Number
Address
City
State
ZIP
E-mail:
This card should be linked to my
Savings Account #
for ATM use only (optional).
II. AUTHORIZATION TO OPEN
ACCOUNT(S)
Please read before signing: By signing
below, I (we) authorize Marine Bank & Trust (Bank) to
verify or obtain further information bank may deem necessary
concerning my (our) credit history. I (we) authorize you to
make whatever credit and/or investigative inquiries deemed
necessary in connection with this application and to exchange
information with others regarding my (our) card transactions.
If this application is approved and a Marine Bank & Trust
Card is issued, I (we) understand I (we) will receive a copy
of the Bank's Electronic Funds Transfer Agreement and Disclosure
and agree to abide by and be bound by its terms.
If I (we) are not approved for the Marine Bank & Trust
Card, I (we) agree that this application will be considered
a Shazam ATM card application and a Shazam ATM card may be
issued to me.
Applicant
Date
Joint Applicant
Date
For Bank Use Only:
Date Received
Approved by
Card #
Card Ordered by
Date Processed
Limits:
Daily
ATM
3 day
JH Processed by
Date Processed
Double check to make sure the application is completely filled
out, print it and sign it, and mail it to:
Attn: New Accounts
Marine Bank & Trust
PO Box 190, 410 Buchanan St
Carthage, IL 62321
Loans 
As required by the