Business CDARS Application

Please fill out the fields in the form below.

One of our representatives will contact you within one business day to complete the process.

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Business Information

Business Name

Business Type

Contact Name

First name

Last name

Permanent Address (Not a P.O. Box)

Street address

City

State

Zip

Use residential address for mailing address

Yes

Mailing Address (if different than above)

Street address (optional)

City (optional)

State (optional)

Zip (optional)

Business Phone

Business Fax (optional)

Tax ID Number

Contact Information

Choose the location you would like to complete your application (optional)

How would you prefer to be contacted?

Phone

Mail

When is the best time to arrange an appointment?

Morning

Lunchtime

Afternoon

Comments (optional)

First State Bank reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, you grant full permission to do so.