Consumer Account Application Form – Fill Out and Use This PDF

Fill in Bank name and Account(s) I Want to Open. Bank Use Only is for the bank.

Under Customer 1 Information and Customer 2 Information, enter the Full name.

Enter the Street address, then How long at the Street address in Yr and Mo.

Under Directional Address, document directional address for customers who do not have physical residence, business or alternate street address.

Enter the City, State, Zip code and Cntry.

Enter the Taxpayer identification number (TIN) and Home phone.

Enter the Previous street address, then How long at the Previous street address in Yr and Mo, then the City, State, Zip code and Cntry.

Enter the Current employer and Business telephone number.

Under Primary ID, enter the Description, State/Country, Issue Date and Exp. Date, and the Date of birth.

Under Secondary ID, enter the Description, State/Country, Issue Date and Exp. Date.

Request for Taxpayer Identification Number and Certification (Substitute Form W-9) Certification: Under penalties of perjury, I certify that: 1) The number shown on this form is my correct Taxpayer Identification Number. 2) UNLESS I HAVE CHECKED ONE OF THE BOXES (I am subject to backup withholding, I am exempt from backup withholding), I am not subject to backup withholding either because I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the IRS has notified me that I am no longer subject to backup withholding (does not apply to real estate transactions, mortgage interest paid, the acquisition or abandonment of secured property, contributions to an Individual Retirement Arrangement (IRA), and payments other than interest and dividends). 3) I am a U.S. person (including a U.S. resident alien). Sign at TIN Certification Signature.

The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

Everything I have stated in this application is correct.

You are authorized to make any inquiries that you consider appropriate to determine if you should open the account.

This may include ordering a credit report or other report (i.e. information from any motor vehicle department or other state agency) on me.

I have received a copy of the applicable account agreement and privacy brochure and agree to be bound by them, including the terms of the Direct Deposit Advance® Service and Deposit AdvanceSM Service (Deposit Advance Service not available in all states) described in the Service Agreement and Product Guide.

I also agree to the terms of the dispute resolution program described in the account agreement and Service Agreement and Product Guide. Under the dispute resolution program, disputes will be decided before one or more neutral persons in an arbitration proceeding and not by a jury trial or a trial before a judge.

Enter the account number(s), Type(s) and TIN under For account number(s).

Customer 1 and Customer 2 each sign at Authorized signature and enter the Date.

Mail your signed Consumer Account Application(s) to: Wells Fargo Services P.O. Box 5110 Sioux Falls, SD 57117-9939. Please do not send deposits to the P.O. Box. Unable to print at this time? Call Wells Fargo Services at 1-800-956-4442 for assistance.