The Citizens Bank

BUSINESS CREDIT CARD APPLICATION

To apply for The Citizens Bank Business Credit Card, you must do so in person at one of our local branch locations. We have made the application available here if you want to fill it out ahead of time. When finished, simply select PRINT at the bottom of the form and bring the signed and printed form into your local branch for further assistance.

The Financial Statement or an attached statement must be completed before your application can be processed. We reserve the right to require additional information.

Company Information

Issue Business Credit Cards to the Following Individuals:

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Second Individual (optional)

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Credit Information

Trade References

First Reference

Second Reference

Third Reference

Condensed Business Financial Statement

SIGNATURE(S)

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING: This statement is submitted to obtain credit and I / We certify that all information herein is true and complete. I / We agree that inquiries may be made to verify information and that credit references or verification may be given based on inquiries from other parties. This application is subject to the credit policies of this institution.. I / We agree to be bound by the terms and conditions of the bank card agreement, a copy of which will be mailed to the applicant if this application is granted, receipt of such agreement and acceptance of such terms to be conclusively presumed by the applicant’s use. If this is a joint application, the undersigned shall by jointly and severally liable for any and all credit extended from time to time.

Balance Transfer

Upon approval, I wish to transfer my present balance on the card account(s) listed below to my new The Citizens Bank credit card account. The balance transfer will be subject to finance charges to the day of posting to your new account.

IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT: To help the government fight the funding of terrorism and money laundering activities, Federal laws require all financial institutions to obtain, verify and record information that identifies each person who opens an Account. What this means to you: When you open an Account, we will ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.

Once you have filled out and printed this form, please sign and date it and then bring it to your local branch for further assistance.