This online form is provided for the purpose of requesting the Department of Banking and Finance's permission to use “bank”, "credit union", “trust” and/or similar word(s) in a name, as required pursuant to O.C.G.A. § 7-1-243.

Please note that "bank", "credit union", "trust" and/or similar word(s) may not be used in Georgia if the entity engages/proposes to engage primarily in the business of lending of money, underwriting or sale of securities, acting as a financial planner, financial service provider, investment or trust adviser, or acting as a loan broker unless such entity is affiliated with a federally insured financial institution.

Download a copy of the full text of O.C.G.A. § 7-1-243 Download this pdf file. here .  See also information regarding creating a new entity on the Secretary of State's website at:

Upon completion and submission of this online request form, your responses are sent real-time to the appropriate Department staff.

Enter the name for which you are seeking the Department's permission
Describe the business purpose(s) of the entity.
If you answered "Yes" to the above question, please describe the relationship with a financial institution.
Reason for use of "bank", "credit union", "trust" or derivative of any of these words in the desired name.
Please provide any other pertinent information to the request
Contact Information

Pursuant to O.C.G.A. § 16-10-20, “[a] person who knowingly and willfully falsifies, conceals, or covers up by any trick, scheme, or device a material fact, or makes a false, fictitious, or fraudulent statement or representation, or makes or uses any false writing or document knowing the same to contain any false, fictitious, or fraudulent statement or entry, in any matter within the jurisdiction of any department or agency of State Government shall be punished by a fine of not more than $1,000 or by imprisonment for not less than one nor more than five years, or both.”

By submitting this application and signing below, the undersigned certifies that the information contained in this application is true, correct, and complete.  The undersigned additionally certifies that he/she understands the penalties for submitting incorrect or false information, including, but not limited to, denial of the application and charges under O.C.G.A. § 16-10-20 as outlined above.  The undersigned further certifies that he/she has the authority to submit this application on behalf of the entity.

Before selecting submit please print a copy for your records