Personal Account Application

What types of banking services do you expect to use at our financial institution on a monthly basis? Fill out to the best of your ability. This is to help us get an idea of the type and amount of activity on your account.

Does the source of any of your funds come from a hemp related business(es) or product(s)? * Yes No

This includes but is not limited to: general retail sales of CDB Oil, Dispensary Sales of CBD oil, Pharmacy Sale of CBD oil, Online sales of CBD oil and Hemp producers of fibers, textiles, seed, meal, oil, imports or exports.

Does the source of any of your funds come from a marijuana related business(es) or product(s)? * Yes No

This includes but is not limited to: adult or medical use, retail, processing, cultivation, testing, operations that support marijuana businesses, landlords of a marijuana business, etc.

Please describe any other services or activities not listed here that you wish to use at our financial institution

We will contact you upon receiving your application to schedule a time that is convenient to finish account opening procedures.

I am aware that I will be required to provide a copy of my Photo ID and social security card, along with EIN verification documentation before account opening. *

By submitting this application, I certify that I gave truthfully and fully provided the information required and that I am at least 18 years of age and live in the U.S.

The purpose of this questionnaire is to begin the application process. All applications are subject to approval.

By entering my name below, I hereby give the electronic equivalent of my signature.