Contact form

Business Account Application

To help the government fight the funding of terrorism and money laundering activities, U.S. Federal law requires financial institutions to obtain, verify and record information that identifies each person (individuals and businesses) 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.








Please provide the Employer Identification Number (EIN) or the Social Security Number (SSN) that the business named above uses for IRS Tax Identification Purposes. (Note: Typically, SSN is only used for individual or sole proprietor businesses).


Please specify the type of Tax ID provided. If you don't have an EIN or SSN and have provided a different number (e.g. foreign ID number), you may select "Other".


INDIVIDUAL WITH CONTROL INFORMATION

Please provide the requested information for one individual with significant responsibility for managing the legal entity listed on this application, such as an executive officer or senior manager (e.g. CEO, CFO, COO, Managing Member, General Partner, President, Vice President or Treasurer) or other individual who regularly performs similar functions.


You may provide "0" in this field if the "Individual with Control" has ownership of less than 25%. If ownership % is provided here, you do not need to identify this individual in the Beneficial Ownership section below.






If you do not have a SSN, please provide a government issued ID or passport to Ficentive and enter "0" in this field.

Admin Login Information

Please provide the information below to allow you to log in and manage your cards.