CONTACT INFORMATION

BUSINESS INFORMATION
ANTICIPATED ACTIVITY (NEEDED FOR AML REQUIREMENTS)
Cash Transactions
Cash Withdrawls
ADDITIONAL AUTHORIZED SIGNERS
First Person
Second Person
AGREEMENTS


SIGNATURES

Account Holder

Joint Account Holder (if applicable)

I/We certify that the information I/we provided on this application is correct and complete. You may, from time to time, give any credit and other information about me/us, including any information on this Form to and receive such information from, any: (a) Credit Bureau or Reporting Agency; (b) Person with whom I may have or propose to have financial dealings; (c) Kush Payments and its subsidiaries or affiliates; and (d) Person in connection with any dealings I have or propose to have with you. We undertake to immediately advise you in writing of any change in any form of identification including but not limited to change of names and addresses and agree to provide such documentation as may be relevant. I/we agree that you may use that information to establish and maintain any relationship with you and to offer me any services from time to time as permitted by law.
ADDITIONAL FILES
Along with the completed above application you must insert or Attach images of the following documents: Owners driver License, State Marijuana license, IRS W-9 form, Business license (if applicable)