Business Name(Required)Assumed Name (if Applicable)Nature of Business(Required)Country of Organization(Required) United States Other Physical Address(Required) Street Address City State / Province / Region ZIP / Postal Code Mailing Address (if different) Street Address City State / Province / Region ZIP / Postal Code Business Phone(Required)Business Email Type of Business(Required) Corporation Limited Liability Corp Non Profit Sole Proprietorship Church Authorized Account Signers Signer 1Name (First & Last)(Required)Email(Required) Phone(Required)Signer 2Name (First & Last)Email PhoneSigner 3Name (First & Last)Email PhoneBusiness Ownership Information Please indicate if there are any beneficial owner(s) and/or control person of the Business: A Beneficial Owner is any individual who owns 25% or more of the business. If the business is a trust, the trustee is the beneficial owner. If another business owns 25% or more percent of this business, please indicate the percentage ownership of the parent company): Name (First & Last)(Required)Percent of Ownership(Required)Name (First & Last)Percent of OwnershipName (First & Last)Percent of OwnershipName (First & Last)Percent of OwnershipExpected Business Activity Does this Business anticipate frequent Large Cash Transactions? (Greater than $3000.00)(Required) Yes No Will the Business utilize mobile depositing?(Required) Yes No Will the Business conduct wire activity?(Required) Yes No Does the Business engage in Internet Gambling(Required) Yes No Are you a Money Service Business or Agent for a Money Service Business?(Required) Yes No Do you conduct Lottery Sales?(Required) Yes No Do you have an ATM on site that you service?(Required) Yes No Would you like to order checks?(Required) Yes No Would you like our Online Banking service?(Required) Yes No We appreciate your interest in establishing a Business Account with Citizens Bank. To continue, please upload your required business documentation using the secure link provided. Required Documents Include: Business formation/registration documents (Articles of Incorporation, Partnership Agreement, LLC Operating Agreement, etc.) Tax ID confirmation (EIN Confirmation Letter, SSN, etc.) Photo ID for all Authorized Account Signers Business license (if applicable) DBA/Fictitious Name Certificate (if applicable) Document requirements may vary based on your business type, structure, and intended account usage Important: To finalize your application and ensure regulatory compliance, we may request supplementary documentation. You will be notified directly of any additional requirements. Timely submission of all requested information helps ensure faster application processing. Submit Your Documents Secure Upload Link The applicant acknowledges that the information provided in this form is true and correct as of the date set forth opposite my signature and that any intentional or negligent misrepresentation of this information contained in this form may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this form, and/or in criminal penalties including, but not limited to, fine or imprisonment or both under the provisions of Title 18, United States Code, Sec. 1001, et seq.; All statements made in this form are made for the purpose of obtaining information only on opening a Business Account. We appreciate your interest in establishing a Business Account with Citizens Bank. A Bank representative will contact you. Need Help? Contact our team at 615.327.9787 extension 300 or email us at citizensbankretail@citizsb.com and we'll be happy to assist you. Δ
