Business Information

  • OK Business Name is required
  • OK Business Type is required
  • Optional OK Website Address (If Applicable) is required
  • OK Contact Name is required
  • OK Permanent Address (Not a P.O. Box) is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Use residential address for mailing address

    OK Use residential address for mailing address is required
  • OK Mailing Address (if different than above) is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Business Phone

    - -
    OK Business Phone is required
  • Business Fax

    - -
    Optional OK Business Fax is required
  • Business Cell Phone

    - -
    Optional OK Business Cell Phone is required
  • OK Tax ID Number is required
  • OK E-mail is required

Contact Information

  • How would you prefer to be contacted?

    Optional OK How would you prefer to be contacted? is required

Authorized Signer

  • OK Name is required
  • OK Title is required
  • Phone

    - -
    OK Phone is required
  • Cell Phone

    - -
    OK Cell Phone is required
  • OK Street Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • Date of Birth

    OK Date of Birth is required
  • OK Employer is required

Additional Authorized Signers

  • How many additional authorized signers do you have?

    OK How many additional authorized signers do you have? is required

Additional Authorized Signer 1

  • OK Name is required
  • OK Title is required
  • Phone

    - -
    OK Phone is required
  • Cell Phone

    - -
    Optional OK Cell Phone is required
  • OK Street Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • Date of Birth

    OK Date of Birth is required
  • OK Employer is required

Additional Authorized Signer 2

  • OK Name is required
  • OK Title is required
  • Phone

    - -
    OK Phone is required
  • Cell Phone

    - -
    Optional OK Cell Phone is required
  • OK Street Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • Date of Birth

    OK Date of Birth is required
  • OK Employer is required

Additional Authorized Signer 3

  • OK Name is required
  • OK Title is required
  • Phone

    - -
    OK Phone is required
  • Optional OK Cell Phone is required
  • OK Street Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • Date of Birth

    OK Date of Birth is required
  • OK Employer is required

Additional Information

  • OK What other Banks do you have accounts with? is required
  • Do you or will you cash checks for people?

    OK Do you or will you cash checks for people? is required
  • Will you cash checks for one person in one day totaling $1,000 or more?

    Optional OK Will you cash checks for one person in one day totaling $1,000 or more? is required
  • Do you or will you perform wire transfer services (Money gram, Western Union, etc.)

    OK Do you or will you perform wire transfer services (Money gram, Western Union, etc.) is required
  • Do you or will you sell money orders?

    OK Do you or will you sell money orders? is required
  • Will you sell them to one person in one day totaling $1,000 or more?

    OK Will you sell them to one person in one day totaling $1,000 or more? is required
  • Do you or will you exchange currency for anyone in amounts totaling $1,000 or more?

    OK Do you or will you exchange currency for anyone in amounts totaling $1,000 or more? is required
  • Will any financial transactions affecting this account originate or have destination outside the US?

    OK Will any financial transactions affecting this account originate or have destination outside the US? is required
  • OK Please Explain is required
  • Types of deposits/withdrawals typically made?

    OK Types of deposits/withdrawals typically made? is required
  • OK Other is required
  • OK Frequency of deposits: is required
  • OK Other is required
  • OK Average Amount of Deposits Expected is required
  • OK Amount of Opening Deposit is required
  • OK Source of Funds is required

Comments

  • Optional OK is required

Security Code

  • OK is required
  • Community Bank will request two forms of identification for each individual/business pertaining to the CD including but not limited to state driver’s license, passport, social security card, insurance card, payroll stub, etc.

    Community Bank reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, you grant full permission to do so.