Form Becu 6873 – Fill Out and Use This PDF

1. Business Information and Ownership: Enter the BUSINESS NAME, the DBA (if applicable), the FEDERAL TAX ID NUMBER (mark EIN, ITIN, or SSN) and the STATE UNIFIED BUSINESS IDENTIFIER (UBI) NUMBER.

Enter the BUSINESS LOCATION / STREET ADDRESS, CITY, STATE / PROVINCE, ZIP / POSTAL CODE and COUNTRY.

Enter the BUSINESS PHONE and the EMAIL ADDRESS (optional).

Enter the "MAILING ADDRESS (if different from above)" box, then CITY, STATE / PROVINCE, ZIP / POSTAL CODE and COUNTRY.

Select your business type: General Partnership, C. Corporation (Profit and Non-Profit), Limited Partnership / Limited Liability Partnership / Limited Liability Limited Partnership / Professional Limited Liability Partnership, Limited Liability Company / Professional Limited Liability Company, S. Corporation, or Other (please specify).

2. Government Required Information: Enter the NUMBER OF EMPLOYEES, the STATE OF ENTITY FORMATION, the DATE BUSINESS ESTABLISHED and the COUNTRY WHERE BUSINESS ESTABLISHED.

Enter the NAICS CODE and the TYPE OF BUSINESS / PRIMARY FUNCTION. North American Industry Classification System is the standard used by Federal Statistic Agencies to classify business establishments.

Locate your NAICS code on the census.gov/naics website, your Federal Tax return, or your Schedule C.

Mark the acknowledgment that your business does not operate in any of the following restricted industries: money transfer services, businesses operating Internet gambling sites or marijuana dispensaries/businesses, and add your Initials.

Mark Yes or No: Does the business receive revenue from a marijuana related business? What is the % of income or revenue from a marijuana related business?

Under Anticipated transaction information, mark Yes or No or N/A: Will your business send domestic wire transfers? Enter the Monthly number of domestic wires sent and the Monthly $ amount of domestic wires sent.

Mark Yes or No or N/A: Will your business send international wire transfers? Enter the Monthly number of international wires sent and the Monthly $ amount of international wires sent.

Mark Yes or No or N/A: Will your business have cash deposits? Enter the Monthly number of cash deposits and the Monthly $ amount of cash deposits. Mark Yes or No or N/A: Will your business have cash withdrawals? Enter the Monthly number of cash withdrawals and the Monthly $ amount of cash withdrawals.

Mark the purpose or types of transactions for which your BECU account(s) will be used: Operating / General purpose or Savings / Investment. Mark Yes or No: Do you have accounts for this business with an institution other than BECU?

Under 3. Certificate of Authority (persons authorized to open this membership with BECU on behalf of the business), sign on the SIGNATURE line and enter the FULL LEGAL NAME, TITLE / POSITION and DATE.

Any action hereto taken by you is hereby ratified and confirmed by the business. Unless or until BECU is given written notice otherwise, you shall have full power and authority to act on behalf of the business.

4. Membership Agreements (Continued on the next page.) Under SECTION 4 REQUIRED SIGNATURES, mark Corporation / LLC or General Partnership / Limited Partnership.

Under Membership Agreement Signatures, for each Individual enter the SSN / TIN, Contact Number (Home, Mobile, or Work), Date of Birth, Mother's Maiden Name, Valid Picture ID Number, ID Type, Issue Date, Expir. Date, State & Country Issued, Street Address, City, State / Province, ZIP / Postal Code and Country. Mark Yes or No: Non-resident alien? If non-resident alien, enter the country of origin. Enter the Business ownership percentage and mark Yes or No: Authorized Signer? Then sign on the Signature line and add the Title and Date.

Certification Instructions: Cross out item 2 above if You have been notified by the IRS that You are currently subject to backup withholding because You have failed to report all interest and dividends on Your tax return.

Cross out item 3 and complete a W-8 BEN if You are not a U.S. person.

5. Additional Authorized Signers (optional): Authorized Signers are able to perform transactions, open or close deposit accounts or services, and add or remove Agents or Non-Authorized Agents on all business deposit accounts.

6. Agents* and Non-Authorized Agents** (ID and address for authentication purposes): enter the NAME and mark Agent or Non-Authorized Agent.

Agents have no authority to act on behalf of the business. Non-Authorized Agents may only access information on all your business accounts in person, in Online Banking, or by calling BECU.

7. Deposit Products and Services: A Business Members Share Savings account is required to establish membership at BECU. Under ACCOUNT (1), mark Business Member Share Savings (required); under ACCOUNT (2), mark Business Basic Checking, Business Interest Checking, Business Money Market Account, or Business Savings.

Certification Regarding Beneficial Owners of Legal Entity Members: under 1. Legal Entity Information, enter the Legal Entity Name, Legal Entity Type, Legal Entity EIN / SSN, Legal Entity Address, City, State / Province, ZIP / Postal Code and Country.

Section 3 is required. Under 3. Beneficial Owner with 25% or More Ownership, provide the following information for each individual, if any, who, directly or indirectly, through any contract, arrangement, understanding, relationship, or otherwise, owns 25 percent or more of the equity interests of the Legal Entity.

If no individual meets this definition, please check the Beneficial Owner with 25% or more ownership not applicable check box below this section, and proceed to section 4.

For each BENEFICIAL OWNER, enter the NAME, TITLE, PERCENT OWNERSHIP, DATE OF BIRTH, SSN, ADDRESS (residential or business street), CITY, STATE / PROVINCE, ZIP / POSTAL CODE and COUNTRY.

For U.S. persons, provide Social Security number (SSN) only. For non-U.S. persons, provide SSN, a passport number, and country of issuance.

6. Certification and Agreement by the Individual Who Completed Section 5 (above): By signing below, I hereby certify, to the best of my knowledge, that the information provided on this form is complete and correct. Sign on the SIGNATURE line and enter the NAME and DATE.

All information is required unless otherwise noted. Please complete application, sign in ink, and bring to a BECU location to apply. To find a BECU location, visit becu.org/locations.