New Business Account Application

Important Information About Procedures for Opening a New 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 person who opens an account.

What this means for you: 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 also ask to see your driver’s license or other identifying documents.

Once we have processed this application, one of our New Account Representatives will be in contact with you to set up an appointment.  Please allow 1-2 banking days. 


* Indicates Required Information

Acct. Holder Info PRIMARY OWNER
Contact Name*
Business Name
D.O.B.* (MM/DD/YY)
SSN*
P.O. Box
Street Address*
City*
State*
Zip Code*
Primary Phone* (000-000-0000)
Secondary Phone* (000-000-0000)

OWNERSHIP OF ACCOUNT

Commercial Accounts
Sole Proprietorship   Corporation Profit Corporation Non-Profit
Unincorporated Association Other LLC

ACCOUNT INFORMATION

Initial Deposit  
Previous Bank  

CHECK ONE OR MORE OF THE ACCOUNTS BELOW TO APPLY FOR:

Commercial Checking Business Statement Savings Certificate of Deposit Business Money Market
Penny Savers Club            

CHECK ONE OR MORE OF THE SERVICES BELOW TO APPLY FOR:

MasterCard Debit Merchant Credit Card Setup Safe Deposit Box Internet Banking
Bill Pay Direct Deposit Payroll Business Loan Line of Credit
Remote Deposit Capture Direct Debit Accounts Receivable        

 

Certification
I certify that I am at least 18 years of age and I have accurately and fully completed all items on this application. Under penalties of perjury, I certify that:
  1. The social security number (SSN) and/or tax payer identification number (TIN) shown above is my correct number;
  2. I am NOT subject to backup withholding because (a) I am exempt from backup witholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the Internal Revenue Service has notified me that I am no longer subject to backup withholding; and
  3. I am a U.S. person (including a U.S. resident alien). 

Or check all that apply:

  I have been notified that I am subject to backup withholding.

  I am not a U.S. citizen or resident (complete W-8) form.

The IRS does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

Please note, this application is subject to verification and approval. In order for us to process your application correctly, we may need to contact you to verify some of the information or request additional documentation. When you submit this application, you certify that everything stated above is true and accurate.  When you submit this application, you also agree that this Institution reserves the right to review your credit history through an authorized bureau.

If you have any questions, please contact us at 319-653-7256, or by e-mail at custservice@federationbankia.com.

By clicking below, I hereby certify that everything I have stated above is correct. You may keep this application whether or not it is approved. By clicking below, I authorize you to check my credit and employment history and verify other information which I have provided to you.