Business Credit Card

Company Information

• Business Name
  OK Business Name is required
• Business Address
  OK Business Address is required
• Business City
  OK Business City is required
• State
  OK State is required
• Zip Code
  OK Zip Code is required
• Primary Contact
  OK Primary Contact is required
• Phone Number
  OK Phone Number is required
• Email Address
  OK Email Address is required

• Revenue above 2.5 Million?

  • Yes
  • No
  OK Revenue above 2.5 Million? is required

• Additional Comments
  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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• • E-Sign Act Disclosure
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• • I/we confirm that I have read and agree to the terms of the E-SIGN Act Disclosure above. I also agree that the Internet access device(s) I/we will use to receive the related legal disclosures, agreements, online account signature form and the instructions meet(s) the system requirements described in the disclosure presented above; and I/we consent to receiving the related legal disclosures, agreements, online account signature form and the instructions electronically.
  You must read and agree to the terms of the E-Sign Act disclosure. Please make sure that you read it carefully and keep a copy for your records. Please agree to the E-Sign disclosure to continue.

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Security Code

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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.