Finance Account Application

FINANCE ACCOUNT APPLICATION

Institution & Account Reference

Institution Name:

Branch/Office:    Internal Reference/Req. #:

Account Requested

Please indicate the account types you request to open (select all that apply):

Applicant Information

Date of Birth:

Country of Citizenship:

Entity Details (If Account Holder is an Entity)

If the applicant is an entity, indicate type (select all that apply):

Date of Formation:

Identification Documents

Acceptable primary ID (select one):

ID Expiration Date:

Beneficial Owner / Authorized Signer

Provide principal beneficial owner or the primary authorized signer for this account.

Date of Birth:

Funding Instructions

Account Agreements, Certifications & Disclosures

By signing below, the applicant certifies that the information provided in this application is true, complete and correct to the best of the applicant's knowledge. The applicant authorizes the institution to obtain verification of any information provided, including consumer and business credit reports and other third-party verifications, as necessary to open and maintain the account. The applicant acknowledges that approval of this application is subject to verification, approval of the institution's compliance department, and is conditioned upon receipt of required identification and documentation.

The applicant consents to the institution's collection, use, and disclosure of information about the applicant for account administration, fraud prevention, anti-money laundering obligations, and regulatory compliance. The applicant warrants that they are duly authorized to open the requested account (if an entity, the signer attests they have authority to bind the entity).

The applicant agrees to be bound by the institution's account agreement, fee schedule, and other terms and conditions provided at account opening. The institution may impose fees, restrictions or limits, and may close or suspend accounts where required by law or where the applicant's actions present a compliance or fraud concern.

Acknowledgement and Signature

The signer certifies they are signing on behalf of the named applicant and have the authority to execute this application. The signer further acknowledges receipt of and agreement to the terms set forth above and understands that the institution may require additional documentation prior to account activation.

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