Business Account Questionnaire

Required Field

Business Information

Business Name Tax ID Number Business Phone Number Business Fax Number

Business Type

Sole Proprietor
Corporation
Partnership
LLC
Non-Profit
Other
Business Type

Street Address City State Zip Code Mailing address is different than street address. Mailing Address City State Zip Code

Signer Information

First Name Middle Initial Last Name Suffix Social Security Number Birth Date Mother's Maiden Name Mailing Address City State Zip Code Daytime Phone Number Home Phone Number E-mail Address Please do NOT email me important news and updates.

How would you prefer to be contacted?

Home Phone
Work Phone
Email
Other
Other Preference

Co-Signer Information

Are you applying as an individual or with a co-signer?

Individual
Co-Signer

How would you prefer to be contacted?

Home Phone
Work Phone
Email
Other
Other Preference

Products and Services Needed

Business Checking
Business Interest Checking
Business Savings
Certificate of Deposit
Business Money Market

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

Endorsement

I certify that all information provided herein is true, correct, and complete. I authorize Valley Bank of Nevada to make any inquiries deemed necessary and to verify information through their fraud detection and credit reporting systems for the purposes of providing the services requested within this application.

Applicant's Signature Date Co-Signers's Signature Date