1. Make The Switch to First Commonwealth Bank

	Individual
	Joint

Primary Account Information		Joint Account Information
First Name			Second Name
Physical Address:			Physical Address:
Street			Street
City			City
State			State
Mailing Address:			Mailing Address:
Street			Street
City			City
State			State
Home Phone			Home Phone
Business Phone			Business Phone
Tax ID # / Soc. Sec. #			Tax ID # / Soc. Sec. #
Driver’s License #			Driver’s License #
Date of Birth			Date of Birth
Place of Birth			Place of Birth
Mother’s Maiden Name			Mother’s Maiden Name
Employer			Employer
Email Address			Email Address