Bank Account Setup – SCG Accounting

SCG Financial Business Advisor

Personal Information Identity Program

Customer Name (First, Middle Initial, Last): *

SSN *

Date of Birth *

Are you an U.S. Citizen *

Yes
No

Work Phone *

Home Phone *

Email *

Employer *

Job Title *

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Business Information Program

Business Name *

Tax ID Number *

Description of Business: *

Number of Employees *

Annual Sales

Business Phone Number *

Business Address *

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Business Website (if not applicable enter N/A) *

Disclosure Authorization

Do you authorize SCG Financial, Inc to release your personal information to Axos Bank to include (Drivers License, State Issue ID, US Passport)? *

Yes
No

Do you authorize SCG Financial Inc to release your information about your business to Axos Bank to include (IRS Form SS-4, State Corporation Commission Cert, Operating Agreement)? *

Yes
No

Do you agree not to hold SCG Financial Inc, and its Business Advisors harmless for any unfavorable business dealings that may arise by banking with Axos Bank bank? *

Yes
No

File Upload: Driver's License, Article of Incorporation, IRS EIN Letter *

Click or drag a file to this area to upload.

Signature *