Commercial Services Information Request Form


Commercial Services Information Request Form












© 2016 First Bank Kansas, All Rights











First Bank Kansas

Commercial Services
Information Request Form



Privacy Policy:

Our privacy policy protects the privacy of your personally-identifying information that you provide us online.

The following form is for commercial use ONLY.

Security Notice:

You should ONLY fill out this form online if you are using a browser with the latest security enhancements. If you don’t have the latest version, download a copy now.

Instructions:

1. Complete this form and click "Submit" or fax it to 785-263-7105. We will contact you to discuss these service(s) within three business days.

2. To safeguard your privacy, QUIT your browser and restart it again after using this form. This form is NOT saved in your computer’s memory when you quit your browser.




Business Information
Business/DBA Name
Tax ID/EIN
Address
City
State
Zip
Business Phone
Business Fax
Business Purpose
Years in Business
Company Website
Business Structure
Corporation
Limited Liability Company
Partnership
Sole Proprietorship
Non-Profit
Municipality
Other
Primary Contact Information
Contact Name
Email
Cell Phone
Best Time to Contact You

Services Interested In:
ACH Services
Merchant eZCapture
Merchant Processing
Commercial Credit Cards
Check Deposit Information (if applicable):
Number of Checks per Deposit
Frequency of Deposits
ACH File Information (if applicable):
Purpose of File
Frequency of File
Additional Comments

Thank you for your interest in our Commercial Services. We will contact you to discuss these service(s) in more detail within three business days.