SFNB-Sole to Joint Form

Authorization to Convert Sole Ownership Account to Joint

S e c o n d a r y A c c o u n t H o l d e r I n f o r m a t i o n
	Please print, sign and mail the completed form to: Security First Network Bank 2957 Clairmont Road Suite 280 Atlanta, GA 30329-1647
Primary Owner Name:	__________________________________________
Account Number:	__________________________________________


Secondary Owner Name:	__________________________________________
Social Security Number:	__________________________________________
Date of Birth:	__________________________________________
Driver's License State:	__________________________________________
Driver's License Number:	__________________________________________
E-mail Address:	__________________________________________
Mother's Maiden Name:	__________________________________________
Telephone:	__________________________________________
Street Address:	__________________________________________
City:	__________________________________________
State:	__________________________________________
Zip Code:	__________________________________________
Employment Status:	__________________________________________
Company:	__________________________________________
Work Street Address:	__________________________________________
City:	__________________________________________
State:	__________________________________________
Zip Code:	__________________________________________
Work Telephone:	__________________________________________

	Please use this document as your authorization to add the name of the person listed above to my existing account and to convert the account from Sole to Joint Ownership:

	________________________________________
	Signature (Primary Owner) Date

	________________________________________
	Signature (Secondary Owner) Date

Send an additional ATM access card:
____ Yes (ATM card PIN will be same as Primary Owner) ____ No

I understand that we will receive new checks with both of our names. Please begin with check number _________.

Questions? Call 1-800-SFNB-321 or send e-mail to SFNB Support. Customer Service can assist you 24 hours a day, 7 days a week.

Copyright ©1995, 1996 Security First Network Bank and Tripod, Inc. All rights reserved.

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