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Company Information

  • OK Business Name is required
  • OK Business Address is required
  • OK Business City is required
  • OK State is required
  • OK Zip Code is required
  • OK Primary Contact is required
  • OK Phone Number is required
  • OK Email Address is required
  • Revenue above 2.5 Million?

    OK Revenue above 2.5 Million? is required
  • Please enter any additional information you would like us to know... OK Additional Comments is required
  • E-Sign Act Disclosure and Consent

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  • By clicking submit below, I/we acknowledge that I/we have read the Account Disclosure and Privacy Policy and agree to the terms and conditions described therein. 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.