Application – pbasda

Download the application here

Fill out our online application here

Application Form

First Name

Last Name

First Name

For a joint account, please give both full names as you want them to appear on the promissory note, which will be sent to you.

Last Name

For a joint account, select one of the following:

and

Joint account

Yes

Address Line 1

Address Line 2

City

State

Zip Code

Country

For your security, our staff will contact you for your Social Security Number (required).

Telephone

Beneficiary 1

Name, address, and telephone number

Beneficiary 2

Name, address, and telephone number

Deposit amount

The minimum deposit is $2,000. The maximum amount invested with PBA is $500,000.

Please select the type of account

New

Existing

I would like my interest

Re-invested

Paid by check

I understand that the money invested in the Professional & Business Association is not insured. However, each loan financed by PBA is guaranteed by the Georgia-Cumberland Conference. My deposit is considered to be a 90-day promissory note. Withdrawal requests are usually processed immediately; however, depending on the withdrawal amount, they may take up to 90 days to be processed.

Signature

Sign Here

Date