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By submitting this electronic form, you certify that all information provided is correct to the best of your knowledge. If any of this information changes, you agree to notify Farmers Savings Bank immediately. With the submission of the form, you authorize Farmers Savings Bank to obtain a credit report in connection with your request for credit. I acknowledge that any intentional misrepresentation of information submitted in this form may result in civil liability and/or criminal penalties.

My transmission of this electronic form as an "electronic record" containing my "electronic signature," shall be as effective, enforceable, and valid as if a paper version of this application were delivered containing my original written signature.

Check "I agree to the terms and conditions" to indicate you have read the above terms and conditions to continue with the electronic form.