Know Your Customer
Required Information Collection Form
To help the United States government fight the funding of terrorism and prevent money laundering activities, U.S. Federal law requires all financial institutions to obtain, verify, and record information that identifies each person (individual, corporation, partnership, trust, estate, or any other entity recognized as a legal person) who opens an account. U.S. Bank will ask for the legal name, address, tax identification number, and other identifying information that will assist us in completing the review of contract/application. We may also ask for copies of certified articles of incorporation, an unexpired government-issued business license, a partnership agreement, or other documents that indicate the existence and standing of the entity. U.S. Federal law also requires financial institutions to conduct ongoing customer due diligence, verify the identity of beneficial owners of certain legal entities, and comply with U.S. Economic Sanctions. U.S. Bank may require identification information on Customer, its Affiliates, Related Parties, or Cardholders, if applicable, to allow U.S. Bank to remain in compliance with U.S. Federal law or U.S. Bank policy. Customer agrees to promptly provide such identification information to U.S. Bank, and Customer shall cause its Affiliates, Related Parties or Cardholders, if applicable, to provide identification information to U.S. Bank.
Answer all questions completely and thoroughly, reviewing the requirements of each section. Do not leave any section blank unless you qualify under Section B. Provide the First, middle (if applicable), and last name for all individuals supplied on this form. Missing information will cause delays in processing. Abbreviations or acronyms are not acceptable. Post Office Boxes or Personal Mailboxes are not acceptable, please provide physical address for any addresses provided. You must notify U.S. Bank if any information contained in the form changes.
Please include legal structure of business (e.g., Corporation, Limited Partnership/LLP, Not-for-Profit Organization, LLC, Single Member LLC, Sole Proprietor).
Provide the full legal name of the customer as it is captured on formation documents, this does not include DBA/Trade names or Operating As names. Examples include Articles of Incorporation, Partnership Agreements, etc. If the entity is a Sole Proprietorship, provide the full legal name, first, middle, last, of the Owner.
Identification Number - (TIN/EIN or an SSN/ITIN if your business does not have its own EIN)
Must be a 9 digit number
Physical Business Address
For home base business, use residential address
PO Boxes & Personal Mailboxes are not acceptable
Does your company have a Doing Business As (DBA)/Assumed Name/Fictitious Name that are applicable to your relationship with U.S. Bank?
Section A: Standard Due Diligence Questions - This section is required to be completed by all applicants
What is the nature of your business?
Include NAICS if known
Does your business operate in the hemp industry?
If yes, supply your USDA License, or State/Tribal Government License when submitting this completed form
What is the legal structure of your business?
e.g., Corporation, Limited Partnership/LLP, Not-for-Profit Organization, LLC, Single Member LLC, Sole Proprietor
What is the company’s country of formation?
What is the country of primary business operations for the company?
What is the company’s estimated or projected annual revenue/budget? (USD)
Whole numbers only (e.g., 1000). No commas or decimal places.
What is the purpose of the account?
Does the company provide any of the following services?
If yes, check those that apply.
Check cashing services
Issue or cash travelers checks or money orders
Provide money transmission or foreign exchange services
Offer prepaid cards
Section B: Individual Related Parties (Authorized Signers)
Authorized signer is the individual(s), who signed the Corporate Payment Systems (CPS) contract document(s) on behalf of the company. This is required for all entities each time this form is completed. The account opener must be a Member or Manager of an LLC, Partner of a Partnership, Business Owner, CEO, Controller or other individual who performs a similar function.
Please fill out one of the following for each individual:
Full Name and Date of Birth
Section C-2: List one individual with responsibility to control, manage or direct the business (e.g., a Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice President, or Treasurer; or any other individual who regularly performs similar management functions.)
No Middle Name
Date of Birth
Physical Residential Address (preferred) or Business Address
PO Boxes are not acceptable
Identification Number- U.S. individuals – SSN or Non-U.S. individual – SSN or Passport Number, Country of Issuance, Issuance & Expiration Dates Copy of Non Expired Document is required with this form
Must be a 9 digit number
Section D: Certification by Account Opener
This section must be completed by an appropriate individual with the authorization of the Customer provided in Section A at the top of this form. e.g., the secretary or other officer, a member or manager of an LLC, partner of a partnership, business owner, Chief Executive Officer (CEO), controller, Chief Operating Officer (COO), Chief Financial Officer (CFO).
I, an Authorized Officer of the company name listed in Section A above, hereby attest that all information supplied on this form and/or any documentation supplied as requested in this form is true and accurate to the best of my knowledge.
No Middle Name
(hold mouse and drag to draw your signature)
Electronic Signature Agreement
By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions.