XA Mobile

Description

Details

Select feature(s)

Additional feature(s)

Add Account Remove Account Save Account OK

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Choose your rate

Specify the amount to deposit

Choose your term

Placeholder text

Maturity Date

Thank you for considering us for your financial services needs. We are sorry that we cannot continue with your application for the following reasons:

Return to Application Cancel Application

Application Cancelled

We have cancelled your application.

If this was a mistake and you would like to fix errors you can return to the application now.

Return to Application

Funding

How much do you want to deposit?

Total Deposit

How do you want to fund your new account?

Not Funding At This Time

Credit Card

Transfer From Another Financial Institution

Mail A Check

Internal Transfer

I agree to fund the account(s) with the method selected

Continue Or Go Back

Done

There was a problem with your request

Let Me Fix Continue

Done

Insufficient Balance

This account does not have sufficient balance to cover the total required deposit.

Please select another account.

Success

Your Google Pay transaction is Successful Ok

Instant Account Verification

We offer a way to instantly verify your account information using . We only use this partner service to retrieve information required to transfer funds from your specified financial institution and to verify that your current balance is sufficient for this transaction.

Continue

Verify account manually instead

By clicking the "Continue" button above, you are agreeing to the terms of our user agreement.

'Doing Business As' Information

DBA Business Information

Company Name

Business Tax ID Type

TIN

SSN

Business Tax ID

Show TIN

Your Business Tax ID is used for identification purposes.

Your Social Security Number (SSN) is used for identification purposes and to determine your account opening eligibility.

Industry

Phone

(xxx) xxx-xxxx

DBA Physical Address

Country

Address

Zip

City

State

Occupancy Status

Occupancy Duration

Use different address for mailing

Mailing Address

Country

Address

Zip

City

State

Continue Or Go Back

Tell Us About Yourself

Optional: Click or tap the card below to pre-fill information with your driver's license.

Personal Information

Are you an employee of Hoosier Heartland State Bank?

SSN

Show SSN

Your Social Security Number (SSN) is used for identification purposes and to determine your account opening eligibility.

First Name

Middle Name

Last Name

Suffix (Jr., Sr., etc.)

Gender

Date of Birth

Mother's Maiden Name

Citizenship Status

Current Physical Address

Country

Address

Zip

City

State

Use different address for mailing

Mailing Address

Country

Address

Zip

City

State

Contact Information

Identification

ID Type

ID Number

ID State

ID Country

ID Date Issued

ID Expiration Date

About Your Employment

Employment Status

Gross Monthly Income (before taxes)

As the custodian for under the Virginia Uniform Transfers to Minor Act, I make this application on the minors

eSignature

Date:

Upload Documents

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 to 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 will also ask to see your driver’s license or other identifying documents.

Thank you for your cooperation

Please upload your identification.

Click or tap here to capture or upload an image or document.

Do you have any beneficiaries?

Yes

Do you have another applicant?

Yes

Continue Or Go Back

Speed up your application process by taking the BACK image of your US driver's license.

If you do not wish to use this feature, simply close this popup window and proceed.

Recommendation for best recognition:

* Use a dark background

* Make sure all four corners are visible

* Avoid glare

* Make sure image is in focus

Done

Speed up your application process by taking the BACK image of your US driver's license.

If you do not wish to use this feature, simply close this popup window and proceed.

Recommendation for best recognition:

* Use a dark background

* Make sure all four corners are visible

* Avoid glare

* Make sure image is in focus

Done

System can't prefill due to ZIP code discrepancy. Please proceed by manually entering the information or correct the value in the ZIP field in the 1st page.

Tell Us About Yourself

Minor Information

Suffix (Jr., Sr., etc.)

Gender

Date of Birth

Mother's Maiden Name

Citizenship Status

Contact Information

Current Physical Address

Country

Address

Zip

City

State

Use different address for mailing

Mailing Address

Country

Address

Zip

City

State

Identification

ID Type

ID Number

ID State

ID Country

ID Date Issued

ID Expiration Date

Continue Or Go Back

About Your Joint Applicant

Optional: Click or tap the card below to pre-fill information with your driver's license.

Personal Information

Are you an employee of Hoosier Heartland State Bank?

SSN

Show SSN

Your Social Security Number (SSN) is used for identification purposes and to determine your account opening eligibility.

First Name

Middle Name

Last Name

Suffix (Jr., Sr., etc.)

Gender

Date of Birth

Mother's Maiden Name

Citizenship Status

Current Physical Address

Country

Address

Zip

City

State

Use different address for mailing

Mailing Address

Country

Address

Zip

City

State

Contact Information

Fund via Internal Transfer

Fund via Credit Card

Alert Popup

Transfer from another financial institution

Co-Driver's License Scan

Driver's License Scan

Open an Account

Application Cancelled

Funding

Fund via Internal Transfer

Fund via Credit Card

Alert Popup

Transfer from another financial institution

'Doing Business As' Information

Tell Us About Yourself

Co-Driver's License Scan

Driver's License Scan

Minor Applicant Information

Joint Applicant Information