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In this section we gather necessary information about the applicant. All fields in bold are required. When you have finished, click Continue.

BB&T currently serves clients within twelve states and the District of Columbia. One of your addresses must be a non P.O. Box address within Alabama, Florida, Georgia, Indiana, Kentucky, Maryland, North Carolina, South Carolina, Tennessee, Texas, Virginia, Washington, D.C., or West Virginia.
 


Applicant
 Name First Middle Last
 Physical Address (No PO Box)

 Address

 Address 2
 City, State, Zip    
 Mailing Address (if different than above)
 Address   (PO Box allowed)
 Address 2
 City, State, Zip    
 Phone (999-999-9999)           Preferred Contact time? 
 Email Address
 Birth Date (mm/dd/yyyy)    Social Security Number (999-99-9999) 
 Marital Status Mother's Maiden Name  
 Are you a U.S. citizen? Are you a BB&T client?  
 Employment Status  Phone (work)  (999-999-9999)   
 ID Type Issue Date (mm/dd/yyyy) 
 ID Number Expiration Date (mm/dd/yyyy) 
 State Issued
 Please select the type of Health Insurance   Coverage you have, Individual or 
 Family. This will help determine your eligibility to open a Health Savings
 Account and the maximum annual contribution you can make to the account.

 HSA Coverage