Certificate of Deposit Application

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Primary Owner
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CD Info
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Certificate of Deposit Application

All required fields are marked by a red asterisk [ * ]

What is your current Zip Code? *

Please note that you will need to have a PDF viewer to read our disclosures and submit this application (CLICK HERE).

Please click the "Next" button to begin your application.

What's your connection to Northern Indiana, Southwest Michigan or 1st Source? *

Moving to the area

Student in the area

Previous resident

Family in the area

Frequent traveler to area

Employer banks with 1st Source

No Connection

All required fields are marked by a red asterisk [ * ]

Joint Owner

Title

First Name *

Middle

Last Name *

Suffix

Social Security/Tax ID *

Date of Birth *

Country of Citizenship *

Primary Phone Number *

Phone Type *

Email Address *

Is the address different than the primary owner's? *

Yes

Address Information

Permanent Address *

Apartment, suite, unit, building, floor, etc.

City *

State *

Zip Code *

Does the joint owner have an active account or loan with 1st Source?

Yes

Identification Information

USA Patriot Act Information

Primary Identification *

ID Number *

State of ID Issuance *

Enter the State the ID was issued.

Date of Issuance *

Expiration Date *

All required fields are marked by a red asterisk [ * ]

Confirm Application & Disclosures

Primary Owner

Name:

Date of Birth:

Social Security / Tax ID:

Primary Phone Number:

Email Address:

Address:

Joint Owner

Name:

Date of Birth:

Social Security / Tax ID:

Primary Phone Number:

Email Address:

Account Information:

Funding Method & Certificate Amount:

Are you working with a particular 1st Source banker or banking center?

Agreement to Receive Electronic Communication *
1.	Please print a copy of this Agreement for your records. This Agreement contains important information. You should read it carefully and keep a copy for your records. CLICK HERE TO PRINT Federal law requires that we obtain your consent before we can provide required disclosures electronically as you complete your online application. By accepting the terms of this agreement, you authorize 1st Source Bank to provide information to you electronically in lieu of certain paper notifications related to the account or product for which you are applying. If you do not wish to proceed with your application online, you can visit any 1st Source Banking Center to complete the application process. Computer Requirements: In order to access, view and retain communications that we make available electronically, you must have: A personal computer or other device that is capable of accessing the Internet. Your access to this page verifies that the system/device you are currently using meets these requirements. An Internet browser that supports 128-bit SSL encryption, such as Internet Explorer (8.0 or newer), Edge, Firefox, Safari or Google Chrome. Your access to this page verifies that the browser and encryption software/device you're currently using meet these requirements. An e-mail account with an Internet service provider and e-mail software capable of sending and receiving email. You must have software that permits you to receive and access Portable Document Format (PDF) files. If you do not have such software, it can be downloaded at http://get.adobe.com/reader/ A printer capable of printing copies of information for your records or sufficient storage capacity on your computer's hard drive or other storage unit, such as a flash drive, to save copies of information for your records. Disclosures can also be accessed online anytime at https://www.1stsource.com/disclosures. Email Address: Electronic communication may be sent to the email address that you have provided to us. If the email is returned as undeliverable, we reserve the right to use postal addresses. Please notify us of any change in your email address by contacting us at (574) 235-4440 or (888) 236-0779. Withdrawal of Consent: There are no fees, conditions, or consequences associated with switching from electronic to paper disclosures. You may withdraw consent to receive electronic disclosures at any time after your online application has been received by contacting us at (574) 235-4440 or (888) 236-0779. Paper Copy: You agree that 1st Source Bank does not need to provide you with an additional paper (non-electronic) copy of the disclosures, notices, terms and conditions, unless specifically requested. If you would like to receive a free paper copy of any information or disclosures that you agreed to receive electronically, please contact us at (574) 235-4440 or (888) 236-0779. Disclosures: All electronic disclosures shall be in compliance with applicable laws and regulations. Terminating this online session prior to submitting the application will automatically withdraw your consent to receive electronic disclosures. Disclosures provided to you electronically may or may not include: Agreement for Deposit – Consumer Accounts, Electronic, Funds Transfer Notice of Disclosure, Truth in Savings Disclosure, USA Patriot Act, Privacy Notice, Electronic Banking Authorization & Disclosure, Electronic Funds Transfer Agreement, 2% Home Equity Line of Credit Program Disclosure (Indiana or Michigan, as applicable), Interest-Only Home Equity Line of Credit Program Disclosure (Indiana or Michigan, as applicable), “What You Should Know About Home Equity Lines of Credit” brochure, Loan Estimate, Service Providers List, Other Important Disclosures, Notice of Furnishing Negative Information, Hazard Insurance Requirements, Housing Counselors, Consumer Caution and Home Ownership (Michigan property only), Borrower’s Bill of Rights (Michigan property only), FHA Prescribed Amendment (FHA only), Important Notice to Homebuyers (FHA only), and Informed Consumer Choice Disclosure Notice (FHA only). Consent: By accepting this agreement, you are confirming that you have the ability to access, view and retain documents through electronic means and further consent to the electronic delivery of the disclosures, notices, terms and conditions pertaining to this application. 02-09-2016 ver. 2.1
2.Before accepting, CLICK HERE to verify your ability to view content in a PDF format. * 3.Check the appropriate response below: Yes, I have verified my ability to read PDF documents and consent to receive disclosures, notices, terms & conditions electronically. No, I was unable to view content in a PDF format. No, I do not consent to receive disclosures, notices, terms and conditions related to this application electronically.

Agreement to Receive Electronic Communication *

Please print a copy of this Agreement for your records. This Agreement contains important information. You should read it carefully and keep a copy for your records. CLICK HERE TO PRINT

Federal law requires that we obtain your consent before we can provide required disclosures electronically as you complete your online application. By accepting the terms of this agreement, you authorize 1st Source Bank to provide information to you electronically in lieu of certain paper notifications related to the account or product for which you are applying. If you do not wish to proceed with your application online, you can visit any 1st Source Banking Center to complete the application process.

Computer Requirements:
In order to access, view and retain communications that we make available electronically, you must have:

A personal computer or other device that is capable of accessing the Internet. Your access to this page verifies that the system/device you are currently using meets these requirements.
An Internet browser that supports 128-bit SSL encryption, such as Internet Explorer (8.0 or newer), Edge, Firefox, Safari or Google Chrome. Your access to this page verifies that the browser and encryption software/device you're currently using meet these requirements.
An e-mail account with an Internet service provider and e-mail software capable of sending and receiving email.
You must have software that permits you to receive and access Portable Document Format (PDF) files. If you do not have such software, it can be downloaded at http://get.adobe.com/reader/
A printer capable of printing copies of information for your records or sufficient storage capacity on your computer's hard drive or other storage unit, such as a flash drive, to save copies of information for your records.
Disclosures can also be accessed online anytime at https://www.1stsource.com/disclosures.

Email Address:
Electronic communication may be sent to the email address that you have provided to us. If the email is returned as undeliverable, we reserve the right to use postal addresses. Please notify us of any change in your email address by contacting us at (574) 235-4440 or (888) 236-0779.

Withdrawal of Consent:
There are no fees, conditions, or consequences associated with switching from electronic to paper disclosures. You may withdraw consent to receive electronic disclosures at any time after your online application has been received by contacting us at (574) 235-4440 or (888) 236-0779.

Paper Copy:
You agree that 1st Source Bank does not need to provide you with an additional paper (non-electronic) copy of the disclosures, notices, terms and conditions, unless specifically requested. If you would like to receive a free paper copy of any information or disclosures that you agreed to receive electronically, please contact us at (574) 235-4440 or (888) 236-0779.

Disclosures:
All electronic disclosures shall be in compliance with applicable laws and regulations. Terminating this online session prior to submitting the application will automatically withdraw your consent to receive electronic disclosures. Disclosures provided to you electronically may or may not include: Agreement for Deposit – Consumer Accounts, Electronic, Funds Transfer Notice of Disclosure, Truth in Savings Disclosure, USA Patriot Act, Privacy Notice, Electronic Banking Authorization & Disclosure, Electronic Funds Transfer Agreement, 2% Home Equity Line of Credit Program Disclosure (Indiana or Michigan, as applicable), Interest-Only Home Equity Line of Credit Program Disclosure (Indiana or Michigan, as applicable), “What You Should Know About Home Equity Lines of Credit” brochure, Loan Estimate, Service Providers List, Other Important Disclosures, Notice of Furnishing Negative Information, Hazard Insurance Requirements, Housing Counselors, Consumer Caution and Home Ownership (Michigan property only), Borrower’s Bill of Rights (Michigan property only), FHA Prescribed Amendment (FHA only), Important Notice to Homebuyers (FHA only), and Informed Consumer Choice Disclosure Notice (FHA only).

Consent:
By accepting this agreement, you are confirming that you have the ability to access, view and retain documents through electronic means and further consent to the electronic delivery of the disclosures, notices, terms and conditions pertaining to this application.

02-09-2016 ver. 2.1

Final Disclosures

Important: By signing this application, I, the primary Account Holder, as required by Federal Law, certify under penalties of perjury that the number shown above as my Taxpayer Identification Number (TIN) is correct, that I am a U. S. person (including a U.S. resident alien) and that (check box if appropriate):*

I am SUBJECT to backup withholdings

I am NOT SUBJECT to backup withholding due to one of the following reasons:

I am an exempt recipient under the Internal Revenue Service Regulations
I have not been notified that I am subject to backup withholding as a result of a failure to report all interest or dividends
I have been notified by the IRS that I am no longer subject to backup withholding.

When submitting your application, you give 1st Source Bank permission to verify your credit history and all the information on your application. Once you have submitted your application online, you will be contacted within one business day by a 1st Source Bank representative.

2.Disclosures *

I AGREE to the disclosures listed above, the testament, and affirm that I am at least 13 years of age. *

1st Source Bank only accepts applications from clients in markets served by a 1st Source Banking Center. Before submitting your application, please read the disclosures listed below. We encourage you to print a copy of this information for your records. To continue with your application, you must click the "I agree" check box indicating you agree with the Account Terms & Conditions and you are at least 13 years old for savings accounts and CDs, 16 years old for checking accounts and 18 years old for debit cards and loans. When submitting your application, you give 1st Source Bank permission to verify your credit history and all the information on your application. Once you have submitted your application online, you will be contacted within one business day by a 1st Source Bank representative.

Agreement for Deposit Accounts (pdf)
Electronic Funds Transfer Notice of Disclosure (pdf)
Truth in Savings Disclosure (pdf)
USA Patriot Act (pdf)
Privacy Policy Notice (pdf) (En Español)

To retain a copy of this application and it's disclosures for your records, click here to PRINT.

Need Help?

574-235-4440 or 888-236-0779
(Mon-Fri 8-5 PM ET)

FAQ

What do I need to apply online?

Accounts cannot be opened online for anyone under the age of 13. At least one applicant must be of legal age in the state in which the account is being opened. You'll need your Social Security number and a valid driver's license or military ID to continue. That's it!

Will 1st Source check my credit when I apply for an account?

No. To process an account application, we use CheckSystems Inc., a consumer-reporting agency, to determine your eligibility. This will have no effect on your credit report or score.

Does it matter if I'm a 1st Source client?

Our application process is quick and convenient for anyone to use. However, current 1st Source clients' applications can be opened entirely online. This is because we already know you and your financial history.

What if I don't have a Social Security or Taxpayer ID?

There may be several instances that you may need to open an account for someone other than yourself, such as:

Trust Account
Beneficiary (Guardianship SS Rep Payee Accts)
Estate Account
Minor (under 16 years old)
Payable on Death
Business / Non-Profit

1st Source is able to service many types of account ownerships which can be completed in one of our conveniently located Banking Centers. Click here to find the nearest Banking Center to you.

What if I am not a US Citizen?

You may apply online provided that you have one of the following valid forms of identification:

Current Passport
US State issued driver's license
State issued ID (issued over 30 days ago)
Matricular Consular

If you have yet received a US Taxpayer ID, please enter '999-99-9999' in the Social Security / Tax ID field. Should you have any further questions, issues or concerns, please contact a representative at 888-236-0779.

FAQ