Deposit Account Application Form

Use this online application to apply for a loan at Liberty Savings Bank. Simply fill out the appropriate fields and then print this form. Bring the printed out application to any Liberty branch location.

Please read the disclosure for information.

Will there be a co-applicant on this deposit application? Yes No

Type of Deposit

It is Liberty Savings Bank’s policy to never sell customer information. Prior to providing Libery Savings Bank with any personal information, would you like to review Liberty Savings Bank’s privacy policy? Click here if you would like to read the policy.

Liberty Savings Bank complies with the Federal Customer Identification Program. Prior to providing Liberty Savings Bank with any personal information would you like to review Liberty Savings Bank Customer Identification Notice?
Click here if you would like to read the notice.

*Fields in red must be answered, if applicable, in order to complete your application.
Application cannot be submitted without providing an E-mail address.
No social security number will be requested. A representative from Liberty Savings Bank will contact you to complete this form and add your social security number.

Primary Applicant
*Last Name
*First Name
*Birth Date mm/dd/yyyy
*E-mail Address
*Address
*City:
*State / ZIP:	/
*Residence Status
*Years at this address
If you have lived at your address less than two years, provide your previous address
*Home Phone (nnn) nnn-nnnn
*Work Phone (nnn) nnn-nnnn
*Employers Name & Address	Self Employed
# of years employed
Postition/Title
Previous Employer Name & Address (if less than 2 years in current position)	Self Employed
# of years employed
Postition/Title

Joint Applicant (If applicable)
*Fields in red must be answered, if applicable, in order to complete your application.

Joint Applicant
*Last Name
*First Name
*Birth Date mm/dd/yyyy
*E-mail Address
*Address
*City:
*State / ZIP:	/
*Residence Status
*Years at this address
If you have lived at your address less than two years, provide your previous address
*Home Phone (nnn) nnn-nnnn
*Work Phone (nnn) nnn-nnnn
*Employers Name & Address	Self Employed
# of years employed
Postition/Title
Previous Employer Name & Address (if less than 2 years in current position)	Self Employed
# of years employed
Postition/Title