Client Bank Registration

Business Legal Name *

Doing Business As (DBA)

Business Address *

City *

State *

ZIP Code *

Country *

Primary Contact Name *

Email Address *

Phone Number *

Bank Name *

Bank Address *

Account Holder Name *

Account Type *

Business Checking

Business Savings

Account Number *

Routing Number *

SWIFT / BIC Code

IBAN

Preferred Payment Method *

ACH Transfer

Wire Transfer

International Transfer

I confirm that the banking information provided is accurate and belongs to the business listed above.

Authorized Signatory Name *

Title / Position *

Signature *

Date

Business Banking Information