Bank of Wausau - A New Tradition in Banking

Products and Services: Open a Deposit Account

Account Opening Form

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 of the requested information. Send your application back to Bank of Wausau by pressing the Submit button at the bottom of the form. All our forms are encrypted for your security, but if you prefer, you may print out this form and mail or fax to:

Bank of Wausau
PO Box 1406
Wausau, WI 54402-1406
FAX# 715-849-4252

* Marks required fields. If opening multiple accounts, please use a separate form for each account. Thank you.

Individual Account Information:

Account Type: *
If CD, what term:
Amount account will be opened with: * (minimum deposit is $1000 for CD)
Source of Deposit: *
Please transfer from my current Bank of Wausau account number:
I will mail in a check or money order
I will send a wire transfer (see instructions at the end of the form)
Other. Please explain:

Applicant Information:
Name: *
Name of joint account owner if any: (see below)
Address: *
City: *
State: *	Zip:*	Country:*
E-mail: *
Home Phone Number : *
Work Phone Number:
Would you like Internet Banking? *	Yes No
If a Trust Account:	Revocable Irrevocable
Date Trust was established
Trustees

Other Instructions or Needs you may have:

Joint Applicant Information: If no Joint Applicant, please skip down

Name of joint account owner:*
Address:*
City:*
State:*	Zip:*	Country:*
E-mail:
Home Phone Number:
Work Phone Number:*

Business Account Information:

Title of Business:*
Type of Business:
Business Street Address:*
Mailing Address (if different)
City/Township:*
Business Phone:*
Authorized Signers and Titles:* (Please give first & last name then title for each person)





Type of Account:
Would you like Internet Banking?	Yes No
After you've completed the new account application, you can submit securely to our bank by pressing the Submit button. A New Account Representative from Bank of Wausau will be contacting you to arrange for you to send the funds to open the account to the bank. Once funds are received by Bank of Wausau, your new account will be set up and important paperwork mailed to you. You will need to sign the required disclosure statements and signature cards in the presence of a Notary Public before returning them to Bank of Wausau. If you have any questions or comments, please contact a New Account Representative at 800-721-0777.