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USA PATRIOT Act Notice:To help the government fight the funding
of terrorism and money laundering activities, Federal law requires all
financial institutions to obtain, verify and record information that identifies
each person who opens an account. Your name, address, date of birth and
other information collected in this application will allow us to identify you.
We may also ask for your driver's license or other identifying documents.
The information you provide will be kept confidential as outlined in Eastern