Business Information

  • OK Business Name is required
  • OK Business Type is required
  • OK Contact Name is required
  • OK Permanent Address (Not a P.O. Box) is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Use residential address for mailing address

    OK Use residential address for mailing address is required
  • OK Mailing Address (if different than above) is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • OK Business Phone is required
  • Optional OK Business Fax is required
  • Optional OK Business Cell Phone is required
  • OK Total Business Revenue is required
  • OK Tax ID Number is required
  • OK E-mail is required

Contact Information

  • OK Choose the location you would like to complete your application: is required
  • How would you prefer to be contacted?

    OK How would you prefer to be contacted? is required
  • When is the best time to arrange an appointment?

    OK When is the best time to arrange an appointment? is required

Comments

  • Optional OK is required
    OK If you provide your contact information you authorize Fidelity Bank or its affiliates to contact you. Your authorization allows us to use text messaging and automatic telephone dialing systems in connection with calls made to any telephone number you provide, even if the telephone number is assigned to a cellular or mobile telephone service or other service for which the called party is charged. You may contact us anytime to change these preferences. is required
    OK By selecting this box I acknowledge that I am not under the age of 13 and approve submission of this information. is required

Security Code

  • OK is required
  • Fidelity 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, I/we grant full permission to do so.