Business Customer Profile Worksheet
Download a blank fillable Business Customer Profile Worksheet in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Business Customer Profile Worksheet with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3Business Customer Profile Worksheet
Critical Notice to New Customers: Federal regulations require all financial institutions to obtain, verify and retain identifying information for each person or
entity that opens an account. Due to these regulations we will ask for the following information and, in addition, upon our discretion, we may ask to see and
copy other identifying documents as part of our review process.
*Completed only for Non-Money Service Businesses – MSBs complete
CM-0006 MSB Application
How did you hear about Merchants Bank of California (MBOC)?
Referred by:_______________________________________________________________________________________
Met Bank Representative at Conference (Please provide name of conference):__________________________________
Other (Specify):____________________________________________________________________________________
SECTION 1: APPLICANT IDENTIFICATION
Name of Business: __________________________________________________________________________________
Fictitious Business Name(s): __________________________________________________________________________
Type of Business:
Sole Proprietorship
Partnership
LP
LLP
Corporation
LLC
Association
Trust/Estate
Client Trust-State Bar account
Non-Profit/Charitable Organization
EIN or SSN (as applicable):
Physical Street Address: _______________________________________________________________________________
City, State:
ZIP or Foreign Country: ____________________
Mailing Address (if different from Physical Address): _______________________________________________________
City, State:
ZIP or Foreign Country: ____________________
Business Telephone:
Fax Number: ____________________________________
E-mail:
Website Address: ________________________________
Number of years the Business has been operating: _________
Does the Business have more than one location under the same Business Name/DBA?
No
Yes
If “Yes”, how many?
(Provide addresses for each location):
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Has this Business or any Affiliated Companies had/or have been required to rescind any permits, licenses, and/or
registrations within the last 5 years for any reason?
No
Yes - provide a written explanation
Has this Business, Parent company, Owners, Directors, or Senior Management ever been charged with or convicted of a
financial crime?
No
Yes - provide a written explanation
SECTION 2: BUSINESS SERVICES OF APPLICANT
Provide Summary of Business Operations:_________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
NA-0012B (Rev.06/13) PC
Page 1 of 3
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business