Application Form for Business
Checking Account

(Preliminary: You will be contacted by the bank.)

HomeTown Bank is restricted, in most cases, to
serving our home and contiguous counties.

Member FDIC

Name:
Date:
Address:
City:
State:
Zip:
Telephone:
Fax:
Email:
Amount of
initial deposit:
Checking Account
Interest-Bearing Account
Contact me at:

Type any questions you have here, and
we will gladly respond with the answers: