Open A New Account

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.

Please provide all the requested information. When you have completed the form, press the Submit button to send your application. You'll hear back from us in two to four working days.

* Indicates a required field

Will there be a co-applicant on this account?

Individual

Joint

Primary Account Owner

First Name*
Last Name*
Business Name	EIN
Social Security Number*
Date of Birth*
Street Address*
City, State, Zip*
Phone Number*
E-Mail Address*	We'll never share your email with anyone else.
Driver's License*
Employer's Name*
Employer's Phone*

Joint Account Owner (if applicable)

First Name
Last Name
Social Security Number
Date of Birth
Address
City, State, Zip
Phone Number
E-Mail Address	We'll never share your email with anyone else.
Driver's License
Employer's Name
Employer's Phone

Account Information

Initial Deposit	$
Previous Bank

Check one or more accounts to apply for:

Personal Account	Business Account
Regular Checking Budget Checking Senior Checking (Age 62 and over) E-Checking Club Clack Checking Now Account Club Clack NOW Account Money Market Account Personal Savings Account Certificates of Deposits IRAs	Business Checking Business Savings Commercial Sweep

Certification

I certify that I am at least 18 years of age and I have accurately and fully completed all items on this application. Under penalties of perjury, I certify that:

The social security number (SSN) and/or tax payer identification number (TIN) shown above is my correct number;
I am NOT subject to backup withholding because (a) I am exempt from backup witholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the Internal Revenue Service has notified me that I am no longer subject to backup withholding; and
I am a U.S. person (including a U.S. resident alien).

Or check all that apply:

I have been notified that I am subject to backup withholding.

I am not a U.S. citizen or resident (complete W-8) form.

The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

Please note, this application is subject to verification and approval. In order for us to process your application correctly, we may need to contact you to verify some of the information or request additional documentation. When you submit this application, you certify that everything stated above is true and accurate. When you submit this application, you also agree that this Institution reserves the right to review your credit history through an authorized bureau.

If you have any questions, please contact us at (503) 668-5501, or by e-mail at ccbank@clackamascountybank.com.

By clicking below, I hereby certify that everything I have stated above is correct. You may keep this application whether or not it is approved. By clicking below, I authorize you to check my credit and employment history and verify other information which I have provided to you.