Personal (Non Business) New Account Risk Assessment
Business Account Interview Worksheet The Credit Union does not open accounts for casinos, internet casinos, internet gambling businesses, businesses selling, producing or storing marijuana, card clubs, securities and commodities firms (brokers, dealers, investment advisors, hedge funds, or commodity traders), insurance companies, dealers (not retailer) in precious metals, stones or jewels, pawnbrokers, loan or finance companies, auto dealerships. The Credit Union does not open accounts for embassies and foreign consulates, foreign businesses, or foreign financial institutions. By initializing, I/we acknowledge and affirm to have read and agree with the above restrictions, and will not open or operate such businesses now, or in the future: ______ ______ ______ ______ PLEASE ANSWER THE FOLLOWING What type of business do you have (i.e., Sole Proprietorship, Corporation, Partnership, etc.)? ___________________ What is the purpose of your business (i.e., retail, restaurant, consultant, etc.)? _______________________________ What is the organization structure (Board of Directors, committees, etc. )? _________________________________ How many locations does your business have and where are they located (city, country)? # of Locations: _________ Full Address 1: _________________________________________________________________________________ Full Address 2: _________________________________________________________________________________ Full Address 3: _________________________________________________________________________________ Full Address 4: _________________________________________________________________________________ (if additional addresses are required, please indicate them at the bottom of the second page) What geographic areas are served? _________________________________________________________________ How long have you operated your current business? ___________
How many people do you employ? ________
Do you plan to perform currency exchanges, check cashing (other than own company checks) in an amount greater than $1,000 for an individual on any day in one or more transactions? Yes No Do you issue or plan to issue, sell or redeem traveler’s checks, money orders, or stored value cards in an amount greater than $1,000 for an individual on any day in one or more transactions? Yes No Do you transmit money or plan to transmit money as a service to your customers?
Yes No
Do you own your own ATM machine(s)? Yes No (this does not mean ATM machines that are placed in the member’s business owned by someone else)
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Business Account Interview Worksheet
CASH REQUIREMENTS Will you be performing transactions by either large cash deposits or withdrawals?
Yes No
If Yes: What is the frequency of your cash deposit: ____________
What is the average cash deposit: ______________
What is the frequency of your cash withdrawal: _________
What is the average cash withdrawal: ___________
WIRE REQUIREMENTS Will you be performing transactions by either incoming or outgoing wire transfers?
Yes No
If Yes: What is the frequency of your wire needs (i.e., daily, weekly, monthly)? ___________________________________ Outgoing wires will be made to: ___________________________________________________________________ Incoming wires will be received from: ______________________________________________________________
PLEASE SIGN AND DATE Member Signature: ______________________________________
Date (mm/dd/yy): ______________________
*By signing above you agree that the SF Fire Credit Union may require audited financial reports upon request.
For Credit Union Use Only Account Number _____________________________
Employee # ___________________________
Date _______________________________________
Risk Rating: ___________________________
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How many people do you employ? ________
Do you plan to perform currency exchanges, check cashing (other than own company checks) in an amount greater than $1,000 for an individual on any day in one or more transactions? Yes No Do you issue or plan to issue, sell or redeem traveler’s checks, money orders, or stored value cards in an amount greater than $1,000 for an individual on any day in one or more transactions? Yes No Do you transmit money or plan to transmit money as a service to your customers?
Yes No
Do you own your own ATM machine(s)? Yes No (this does not mean ATM machines that are placed in the member’s business owned by someone else)
(033112)
1
Business Account Interview Worksheet
CASH REQUIREMENTS Will you be performing transactions by either large cash deposits or withdrawals?
Yes No
If Yes: What is the frequency of your cash deposit: ____________
What is the average cash deposit: ______________
What is the frequency of your cash withdrawal: _________
What is the average cash withdrawal: ___________
WIRE REQUIREMENTS Will you be performing transactions by either incoming or outgoing wire transfers?
Yes No
If Yes: What is the frequency of your wire needs (i.e., daily, weekly, monthly)? ___________________________________ Outgoing wires will be made to: ___________________________________________________________________ Incoming wires will be received from: ______________________________________________________________
PLEASE SIGN AND DATE Member Signature: ______________________________________
Date (mm/dd/yy): ______________________
*By signing above you agree that the SF Fire Credit Union may require audited financial reports upon request.
For Credit Union Use Only Account Number _____________________________
Employee # ___________________________
Date _______________________________________
Risk Rating: ___________________________
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