Free Bank Request for Information Form Template

Bank Request for Information Form

Please fill out the form with your information below.

Requestor Information

Name

    Address

      Phone number

        Email

          Information Requested

          Account Holder Name

            Account Number

              Type of Account

                • Checking

                • Savings

                Account Opening Date

                  Current Balance

                    Purpose of Request

                      • Verification of Account

                      • Loan/Line of Credit Application

                      • Legal/Tax Requirement

                      Authorization and Signature

                      By signing this form, I authorize the bank to release the requested information to the undersigned. I confirm that the information provided in this form is accurate and that I am authorized to request this information on behalf of the account holder(s).

                      Date:

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