Business Account Application

To help the government fight the funding of terrorism and money laundering activities, the USA Patriot Act 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, physical address, date of birth, and tax payer identification number (Social Security #) and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents. We will let you know if additional information is required.

General

Type of Account Ownership of Account

Please note: profit organizations or entities (such as corporations, partnerships, limited liability companies, business trust, etc.) are not eligible for NOW or Super NOW accounts.

Business Information

Name of Business EIN Business Phone Number Cell Phone Number Business Type Street Address City State Zip Code Mailing address is different than street address.

Mailing Address City State Zip Code

Does this business engage in unlawful internet gambling? Yes No

Does this business perform check cashing or money transfers? Yes No

Does this business perform sales of money orders or lottery tickets? Yes No

Business Owner Information

First Name Middle Initial Last Name Social Security Number Birth Date Mother's Maiden Name Birth City Mobile Phone Number Work Phone Number E-mail Address Street Address City State Zip Code Mailing address is different than street address.

Mailing Address City State Zip Code

Occupation Employer Name Nearest Relative Not Living With You Relationship (of Relative) Phone Number (of Relative) Address (of Relative) City (of Relative) State (of Relative) Zip Code (of Relative)

Account Preferences

Check all that apply Internet Banking ACH Origination Mobile Deposits Check Blanks Bill Pay

Commercial Customer Due Diligence Questionaire

Describe your products and services

How long have you owned this businesss?

Years Months Not Applicable

How long have you managed this business?

Years Months Not Applicable What percentage of your gross revenue is derived from money services (for example, check cashing, selling or redeeming travelers checks, money transmission)?

List each of your owned business locations below (physical address)

Business Address

Street Address City State Zip Code

Describe your USA Market Area and customer base.

Check all that apply Local County Residents Multi-state area residents Local statewide residents USA citizens International customers, regardless of citzenship

Please describe your primary target market and any other customer groups to whom you market your services to

What type of state business licenses do you hold?

Check all that apply General Business License Check Cashing Business License Special Purpose Business License Money Transmitter Business License Other Business License Not Applicable

Does the business process any transactions on behalf of another entity or individual? Yes No

Please Explain

Which of our branches do you intend to use to conduct business?

Check all that apply Bowman Loan (North) Bowman Operations (South) Scranton Hettinger Regent Rhame

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.

Please explain your involvement with hemp

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 marjiuana businesses, landlords of a marijuana business, etc.

Please explain your involvement with marijuana

Do you have any Automated Teller Machines (ATM's) installed at any of your business locations? Yes No

How many ATM's? What are the physical locations of those ATM's? Monthly # of withdrawals for each machine? Monthly $ withdrawal amount for each machine? How much cash does the ATM hold? Source of cash replenishment for each ATM such as normal business, other ATM vendor, etc.