Єгоричева С.Б. Організація діяльності банків у зарубіжних країнах
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A cct:
New Account Application – Business Accounts
Mail to: Customer Care:
Countrywide Bank, N.A. (866) 462-8104
5401 N. Beach Street
Mailstop: FWBS-752
Fort Worth, TX 76137
Note: Please contact us if mailing the application at
1-866-462-8104 so that we can confirm receipt upon delivery.
All supporting documentation must be submitted when applying for an
account. Please see documentation requirements in the attached “Exhibit I.”
Any application received without the supporting documentation will be con-
sidered incomplete.
Business Classification ( One):
k Corporation k Corporation – Not For Profit k
LLC k LLP
k Partnership k Association k Sole Proprie-
torship k Other
Business Information
Name of Business
Mailing Address Suite
Cit State Zip Code
Physical Address Suite:
City State Zip Code
Business Phone ( ) Fax ( )
Tax ID Date Business Established Annual Revenues
Number of Employees Type of Business
198
Owner/Authorized Signer Information k Owner
US Citizen k Yes k No k Authorized Signer
(Authorized Signers fill in Name, Mother’s
Maiden Name and ID information only)
Name % of Ownership
Title at Business Home Phone ( )
Personal Address
City State Zip Code
SSN # DOB Mother's Maiden Name
ID Type ID Number State Issue Date
Expiration Date
Owner/Authorized Signer Information k Owner
US Citizen k Yes k No k Authorized Signer
(Authorized Signers fill in Name, Mother’s
Maiden Name and ID information only)
Name % of Ownership
Title at Business Home Phone ( )
Personal Address
City State Zip Code
SSN # DOB Mother's Maiden Name
ID Type ID Number State Issue Date
Expiration Date
Owner/Authorized Signer Information k Owner
US Citizen k Yes k No k Authorized Signer
(Authorized Signers fill in Name, Mother’s Maiden Name and ID in-
f
ormation only)
Name % of Ownership
Title at Business Home Phone ( )
Personal Address
City State Zip Code
SSN # DOB Mother's Maiden Name
ID Type ID Number State Issue
Date Expiration Date
199
Please select one or more products for which you would like to apply.
Money Market Checking Account
k Business MMDA Opening Deposit $
Certificate of Deposit
Desired Term ( One) Interest Payment ( One) CD Amount
k 3 months k Reinvest Interest $
k 6 months k Monthly Interest Checks $10,000 minimum
k 9 months k Transfer to your Countrywide Bank Business
k 12 months MMDA Account #
k 18 months
k 24 months
How would
y
ou like to fund
y
our ac- Wire Instructions
Countrywide Bank, N.A.
ABA Number 0560-0911-0
Credit Countrywide Bank
Source: WF1
200
Please sign and have all authorized signers sign and date the form below.
READ THESE STATEMENTS BEFORE SIGNING: All Country-
wide Bank deposits are subject to all applicable rules and regulations
adopted by Countrywide Bank, National Association (“the Bank”). I have
read and agree to the terms of the Application Disclosure Handbook, a copy
of which has been provided to me, as well as to the terms set forth in the fol-
lowing paragraphs. I acknowledge that the signatures below signify such
agreement and will also be used for purposes of identity verification.
IMPORTANT INFORMATION ABOUT PROCEDURES WHEN
YOU APPLY FOR AN ACCOUNT: The Bank complies with Section 326
of the USA PATRIOT Act which requires financial institutions to obtain,
verify, and record information that identifies each person who opens or has
signature authority on an account. What this means for you: When you apply
for an account, you will be asked 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 and other identifying documents.
CREDIT VERIFICATION; CONSUMER REPORTS: You agree that
we may obtain consumer reports on any of you now and in the future when
opening, updating, renewing, or extending your account. We may do so at
the time you open your account, at any time while your account is open, or
after your account is closed if you owe us any amount related to your ac-
count and in accordance with applicable law.
SUBSTITUTE W-9 CERTIFICATION (The Internal Revenue Service
does not require your consent to any provision of this document other than
the certifications required to avoid backup withholding.)
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification
number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from
backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure
to report all interest or dividends, or (c) the IRS has notified me that I am no
longer subject to backup withholding, and
3.
I am a U.S. person (including a U.S. resident alien) as designated above.
Certification instructions. You must cross out item 2 above if you have
been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax re-
turn. For real estate transactions, item 2 does not apply. For mortgage inter-
est paid, acquisition or abandonment of secured property, cancellation of