Business Deposit Account Application

This secure online form will help organize the information and documentation required to open a new business account at Kitsap Bank. Please complete the form and click, “Submit”. By clicking “Submit”, you indicate that you intend to open an account with Kitsap Bank. A Kitsap Bank representative will contact you shortly. To complete the application process, you will be asked to stop by the Kitsap Bank branch most convenient to you.

At this time, we will only accept applications from businesses located in the State of Washington.

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Business Name	DBA (Doing Business As)
Employer Identification # or Sole Proprietor's Social Security #
Physical Address
City	State Choose...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming	Zip Code
Mailing Address
City	State Choose...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming	Zip Code
Business Phone	Business Fax
Current Date* JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 01020304050607080910111213141516171819202122232425262728293031 20082009201020112012201320142015

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Type of Business Choose...Sole ProprietorshipPartnershipLimited Liability Partnership (LLP)CorporationLimited Liability Company (LLC)Non-Profit Organization/Association
Account Type Choose...Commercial CheckingChexPlus Checking (only sole proprietorships and non-profits)Free Business CheckingStatement SavingsIRA Statement SavingsMarketFundPremium FundMoney Market PlusTime Certificate-Variable Rate (6 months and above)Time Certificate-Fixed RateUndecided. Need more information. View Account Options	Term, If Applicable Choose...32 Day60 Day90 Day6 Month9 Month12 Month18 Month24 Month30 Month36 Month48 Month60 Month
Expected Opening Deposit View Rates for required account minimums.
Kitsap Bank branch most convenient to you Choose...6th & Pacific-BremertonAllynBainbridge IslandBay Street-Port OrchardBelfairBethel & Lund-Port OrchardBonney LakeHwy 303-BremertonWheaton Way-East BremertonKingstonMarine Drive-West BremertonMount Baker Building-Port TownsendPioneer Way-Gig HarborPoint Fosdick-Gig HarborPort AngelesPort HadlockPort LudlowEast Sims-Port TownsendPoulsboEast SequimWest SequimSheridan Village-BremertonSilverdaleSouth Park Village-Port Orchard (This is the branch where you expect to complete the majority of your banking transactions)

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Authorized Signers: For each signer on the account, please furnish the following:

Primary Account Signer Information

Salutation Choose...Dr.Mr.Ms.Mrs.Miss
*First Name	Middle Initial
*Last Name	Title
Access Word for This Account	*Social Security Number

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*Primary Identification Choose...Driver’s LicenseMilitary IDPassportState-issued Identification Card	Number
Issue Date	Expiration Date

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*Secondary Identification Choose...Driver’s LicenseMilitary IDPassportState-issued Identification CardCredit CardCompany Identification Card	Expiration Date
If using a credit card, what type?	Issuer
Issue Date

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*Date of Birth
Primary Phone Number		Secondary Phone Number
	Choose...HomeWorkCell		Choose...HomeWorkCell
Mailing Address
City	State	Zip Code
	Choose...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
*Physical Address
*City	*State	*Zip Code
	Choose...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Email Address

Have more signers? Click Here

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*Required information.

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Would you like an application for a Kitsap Bank Visa debit card with this account?YesNo

Would you like to order Kitsap Bank checks?YesNo
View Check Options

Are you interested in enrolling for Online Banking or Cash Management Services?YesNo

I would like more information about:

Online Banking	Deposit Connect	Commercial Loans
Online Bill Pay	Merchant Bankcard Services	Builder Financing
Cash Management Services	Health Savings Accounts	All-In-One Construction Loans
Retirement Planning	SBA Loans

Comments

Additional documents required:

Business Type	Identification	Tax ID Number	Documentation
Sole Proprietorship	Proprietor(s) ID	Proprietor's Social Security Number or Employer Identification #	Copy of Business License
Partnership	General Partner(s)	Employer Identification #	Business License
Limited Liability Partnership (LLP)	General Partner(s)	Employer Identification #	Business License Copy of Limited Partnership Certificate filed with Secretary of State
Corporation	Principle Officers	Employer Identification #	Business License Copy of Article of Incorporation filed with Secretary of State
Limited Liability Company (LLC)	Managers, Member and Authorized Signers	Employer Identification #	Business License Copy of LLC Certificate filed with Secretary of State
Non-Profit Organization/Association	Authorized Signers	Employer Identification #	Current copy of minutes of Board Meeting authorizing signers

USA Patriot Act Notice:  To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account. Your name, address, date of birth and other information collected in this application will allow us to identify you. We may also ask for your driver’s license or other identifying documents.

By submitting this application, the applicant and any co-applicant (each referred to as “I”, “my”, and “me”) each represent that all the information in this application is true and correct. I authorize you to obtain any information about me that you believe is necessary to evaluate this application, including consumer reports from consumer reporting agencies. I agree to accept the terms of this account which will be mailed to me upon receipt of this application.

Privacy Statement                    Fee Schedule                    Terms and Conditions

Print and retain this form for your records. Rates are subject to change prior to completing the account opening process. As a reminder, you will be contacted by a Kitsap Bank representative. To complete the application process, you will be asked to stop by the Kitsap Bank branch most convenient to you. Two pieces of identification will be required for each account holder.

Thank you for applying for a business account with Kitsap Bank. We look forward to serving you! If you have any questions, please contact our Customer Service Center at 800-283-5537.