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Business Information Form
(For Non-Individuals)
IMPORTANT INFORMATION ABOUT OPENING AN ACCOUNT
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 customer who
opens an account. When you open an account, we will ask for your name, address, date of birth and
other information that will allow us to identify you. We may ask to see your driver’s license or other
identifying documents.
(CIP applies to all new accounts including businesses, individuals, trusts and estates. This is also applicable for the signers on
any of these accounts.)
Date: Password:
Business Name:
Physical Street Address:
City State Zip:
Mailing Address:
If different from Physical Address
City State Zip:
If different from Physical Address
EIN: Business Phone:
Business Type: Association/Organization Corporation Limited Liability Corporation
Money Service Business Partnership Sole Proprietor
Other:
Principal Business Activity:
REQUIRED – Be Specific
Documentation Requirements
Document Type
Received
Pending
Articles of Incorporation
Articles of organization
Partnership Agreement
Trust Agreements
Copy of EIN Application
Business License
Resolution of Authority
Personal Information Sheets
Copies of Driver’s Licenses and Social Security Cards
Verification
Verification Type
Yes
No
ChexSystems
OFAC
Secretary of State Report
Port: Date: Initials: