Online Banking & Bill Pay

Online Banking & Bill Pay

Apply Online - It's Safe, Secure & Easy

To begin, please fill out the fields in the form below. One of our representatives will contact you within one business day to complete the process.

This form uses 256 bit SSL encryption, ensuring that no one else will see your personal information while it is in transit. Please view our Privacy Statement for more information.

Customer Information:

  • Are you a new customer?

    OK Are you a new customer? is required

Personal Information:

  • OK Name is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • Date of Birth

    OK Date of Birth is required
  • Home Phone

    - -
    OK Home Phone is required
  • Daytime Phone

    - -
    Optional OK Daytime Phone is required
  • OK Mother's Maiden Name is required
  • OK Driver's License or State ID Number is required
  • OK State of Driver's License is required
  • OK Occupation is required
  • OK Employer is required
  • OK Email is required

Address Information:

  • OK Residential Address (Not a P.O. Box) is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Use residential address for mailing address

    OK Use residential address for mailing address is required
  • OK Mailing Address (if different than above) is required
  • OK City is required
  • OK State is required
  • OK Zip is required

Joint Account Information:

  • Number of Joint Owners on this Account

    OK Number of Joint Owners on this Account is required

Joint Applicant #1:

  • OK Relationship to Primary Applicant is required
  • OK Name is required
  • Date of Birth

    OK Date of Birth is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • OK Drivers License Number is required
  • OK State Licensed Issued is required
  • Home Phone

    - -
    OK Home Phone is required
  • Work Phone

    - -
    OK Work Phone is required
  • OK Residential Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required

Joint Applicant #2:

  • OK Relationship to Primary Applicant is required
  • OK Name is required
  • Date of Birth

    OK Date of Birth is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • OK Drivers License Number is required
  • OK State License Issued is required
  • Home Phone

    - -
    OK Home Phone is required
  • Work Phone

    - -
    OK Work Phone is required
  • OK Residential Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required

Debit Card:

  • Would you like to receive a debit card?

    OK Would you like to receive a debit card? is required

Online Banking:

  • Would you like to enroll in online banking?

    OK Would you like to enroll in online banking? is required

Comments:

  • Optional OK Comments is required

Security Code:

  • OK is required
  • Heritage Bank of the Ozarks reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, I/we grant full permission to do so.

  • This document is being secured using SSL encryption provided by your browser. Your information will be encrypted when using this form while in transit between your browser and Heritage Bank of the Ozarks.