Business Checking Application
Not for Profit
Personal Information
Owner Name:
*
First Name
Last Name
Owner's Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth:
*
-
Month
-
Day
Year
Date
Business Operations Information
Does the business cash checks?
*
Yes
No
If yes (cash checks), does the business cash more than $1,000/person per day?
Yes
No
Does the business sell money orders?
*
Yes
No
Does the business transmit money? (e.g. wire transfers, Wester Union, etc.)
*
Yes
No
Does the business exchange currency and/or cryptocurrency?
*
Yes
No
Is the business cash intensive?
*
Yes
No
Does the business issue prepaid cards?
*
Yes
No
Does the business sell lottery tickets?
*
Yes
No
Does the business engage in internet gambling?
*
Yes
No
Does the business own or operate privately-owned ATMs?
*
Yes
No
Does the business rent ATMs?
*
Yes
No
Does the business engage in Hemp or marijuana-related business?
*
Yes
No
Does the business derive any income, directly or indirectly, from hemp or marijuana-related business?
*
Yes
No
Does the business invest in hemp or Marijuana-related business?
*
Yes
No
Does the business invest in, or conduct transactions with cryptocurrency?
*
Yes
No
Is there seasonality to the business operations?
*
Yes
No
If yes (seasonality), note high season:
Anticipated Account Activity:
Does the business anticipate making cash deposits?
*
Yes
No
If yes (cash deposits), note Amount and Frequency:
Does the business anticipate making cash withdrawals?
*
Yes
No
If yes (cash withdrawals), note Amount and Frequency:
Does the business anticipate sending or receiving domestic wire transfers?
*
Yes
No
Does the business anticipate sending or receiving international wire transfers?
*
Yes
No
Will the business use remote deposit or other cash management services?
*
Yes
No
Will the business be using mobile banking?
*
Yes
No
Will deposits be made via mobile application?
*
Yes
No
Does the business anticipate using ACH-related services (e.g. PayPal, Venmo, etc.)?
*
Yes
No
Please complete the following section for each individual that is a director or controlling member (3 max):
Director/Controlling Member 1 Name:
First Name
Last Name
Director/Controlling Member 1 Phone Number:
Please enter a valid phone number.
Director/Controlling Member 1 Email:
example@example.com
Director/Controlling Member 1 Business Title (Director, Controlling Member):
Director/Controlling Member 1 Ownership Share (%):
Is Director/Controlling Member 1 Authorized Signer?
Yes
No
Does Director/Controlling Member 1 require a Debit Card?
Yes
No
Does Director/Controlling Member 1 require Online/Mobile Access?
Yes
No
Click to input additional Director/Controlling Member's information
Director/Controlling Member 2 Name:
First Name
Last Name
Director/Controlling Member 2 Phone Number:
Please enter a valid phone number.
Director/Controlling Member 2 Email:
example@example.com
Director/Controlling Member 2 Business Title (Director, Controlling Member):
Director/Controlling Member 2 Ownership Share (%):
Is Director/Controlling Member 2 Authorized Signer?
Yes
No
Does Director/Controlling Member 2 require a Debit Card?
Yes
No
Does Director/Controlling Member 2 require Online/Mobile Access?
Yes
No
Click to input additional Director/Controlling Member's information
Director/Controlling Member 3 Name:
First Name
Last Name
Director/Controlling Member 3 Phone Number:
Please enter a valid phone number.
Director/Controlling Member 3 Email:
example@example.com
Director/Controlling Member 3 Business Title (Director, Controlling Member):
Director/Controlling Member 3 Ownership Share (%):
Is Director/Controlling Member 3 Authorized Signer?
Yes
No
Does Director/Controlling Member 3 require a Debit Card?
Yes
No
Does Director/Controlling Member 3 require Online/Mobile Access?
Yes
No
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Please complete the following section for each non-person owner (3 max):
Non-person Owner 1 Business Name:
Non-person Owner 1 Business Type:
S Corp
C Corp
Sole Proprietor
Not for Profit
Non-person Owner 1 Business Email:
example@example.com
Non-person Owner 1 Business Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Non-person Owner 1 Business Phone Number:
Please enter a valid phone number.
Non-person Owner 1 Primary Contact Name:
First Name
Last Name
Non-person Owner 1 Primary Contact Email:
example@example.com
Non-person Owner 1 Primary Contact Phone Number:
Please enter a valid phone number.
Click to input additional non-person owner's information
Non-person Owner 2 Business Name:
Non-person Owner 2 Business Type:
S Corp
C Corp
Sole Proprietor
Not for Profit
Non-person Owner 2 Business Email:
example@example.com
Non-person Owner 2 Business Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Non-person Owner 2 Business Phone Number:
Please enter a valid phone number.
Non-person Owner 2 Primary Contact Name:
First Name
Last Name
Non-person Owner 2 Primary Contact Email:
example@example.com
Non-person Owner 2 Primary Contact Phone Number:
Please enter a valid phone number.
Click to input additional non-person owner's information
Non-person Owner 3 Business Name:
Non-person Owner 3 Business Type:
S Corp
C Corp
Sole Proprietor
Not for Profit
Non-person Owner 3 Business Email:
example@example.com
Non-person Owner 3 Business Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Non-person Owner 3 Business Phone Number:
Please enter a valid phone number.
Non-person Owner 3 Primary Contact Name:
First Name
Last Name
Non-person Owner 3 Primary Contact Email:
example@example.com
Non-person Owner 3 Primary Contact Phone Number:
Please enter a valid phone number.
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