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RETURN INSTRUCTIONS Upload/Secure Message Log in at ally.com, (Ally Bank)

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  • 14 check-boxes
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RETURN INSTRUCTIONS
Return this form with any attached documents using one of these methods:
Upload/Secure Message
Log in at ally.com, choose Email / Bank Accounts / Send a New Secure Message.
Mail
Ally Bank
PO Box 951
Horsham, PA 19044
Fax
Subject Line: Operations
Fax Number: 866-699-2969
INDIVIDUAL / JOINT ACCOUNT APPLICATION
INTEREST CHECKING HIGH YIELD 6-MONTH CD
NO PENALTY 11-MONTH CD HIGH YIELD 18-MONTH CD
ONLINE SAVINGS ACCOUNT HIGH YIELD 9-MONTH CD
RAISE YOUR RATE 2-YEAR CD HIGH YIELD 3-YEAR CD
MONEY MARKET SAVINGS ACCOUNT HIGH YIELD 12-MONTH CD
RAISE YOUR RATE 4-YEAR CD HIGH YIELD 5-YEAR CD
HIGH YIELD 3-MONTH CD TOTAL
Product Type
Special Instructions:
Product TypeQuantity QuantityAmount Amount
$ $
$ $
$ $
$ $
$ $
$ $
$ $
Important Notifications
each person who opens an account. What this means for you: when you open an account, we will ask for your name, a street address, date of birth, and
to identify you.
We only open accounts for legal U.S. residents. By signing and submitting this application, you are acknowledging that you are a U.S. citizen or resident
alien of the U.S.
If you have a freeze on your credit as a feature of credit security monitoring, we may contact you to lift the freeze temporarily to verify your identity.
You authorize us to contact you by using any telephone number you provide to us, including a mobile or cell phone number that you are authorized to
you for any contact, but your mobile phone service provider may.
1
Account Product Type and Selection
Individual Account Is this Account: Payable on Death (POD)? In Trust For (ITF)?
Is this Account: Payable on Death (POD)? In Trust For (ITF)?
Yes Yes
Yes YesJoint Account
No No
No No
Primary Applicant Information
EMAIL ADDRESS
RESIDENTIAL STREET ADDRESS (NO PO BOXES)
RESIDENTIAL ADDRESS LINE 2 MAILING ADDRESS LINE 2
(Complete only Name, Social Security Number, Occupation, Employer, and Date of Birth information below)
FIRST NAME M.I. LAST NAME / SUFFIX SOCIAL SECURITY
DATE OF BIRTH
EMAIL ADDRESS
RESIDENTIAL STREET ADDRESS (NO PO BOXES)
RESIDENTIAL ADDRESS LINE 2
MAILING ADDRESS (IF DIFFERENADDRESS (IF DIFFERENT T THAN RESIDENTIAL)THAN RESIDENTIAL)
MAILING ADDRESS LINE 2
Ally Bank, Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT WWW.ALLY.COM
UPDATED 02/2020
PERSONAL PHONE WORK PHONE
2
Applicant Information (continued)
STATE ZIP
If you have been at the above address for less than 5 years, provide a prior residential address, and a copy of one of the following for address
verification: Driver’s License, state issued ID card or utility bill (not greater than 60 days).
RESIDENTIAL STREET ADDRESS (NO PO BOXES)
STATE ZIPRESIDENTIAL STREET ADDRESS (NO PO BOXES) RESIDENTIAL CITY
RESIDENTIAL CITY
SECURITY QUESTION
SECURITY QUESTION
SECURITY ANSWER
SECURITY ANSWER
EMAIL ADDRESS PERSONAL PHONE WORK PHONE
RESIDENTIAL STREET ADDRESS (NO PO BOXES)
RESIDENTIAL ADDRESS LINE 2
RESIDENTIAL CITY MAILING CITYSTATE STATEZIP ZIP
MAILING ADDRESS (IF DIFFERENT THAN RESIDENTIAL)
MAILING ADDRESS LINE 2
INDIVIDUAL / JOINT ACCOUNT APPLICATION
Ally Bank, Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT WWW.ALLY.COM
RESIDENTIAL CITY MAILING CITYSTATE STATEZIP ZIP
If you are not an Ally Bank customer, provide a security question with answer and mother's maiden name that may be used to identify you when contacting us.
Secondary Applicant Information
If you have been at the above address for less than 5 years, provide a prior residential address, and a copy of one of the following for address
verification: Driver’s License, state issued ID card or utility bill (not greater than 60 days).
If you are not an Ally Bank customer, provide a security question with answer and mother's maiden name that may be used to identify you when contacting us.
UPDATED 02/2020
(Complete only Name, Social Security Number, Occupation, Employer, and Date of Birth information below)
FIRST NAME M.I. LAST NAME / SUFFIX SOCIAL SECURITY
DATE OF BIRTH
You can choose up to 10 beneficiaries for each of your non-IRA accounts. If you have more than one beneficiary, each will receive an equal amount of funds
from your account unless you adjust your allocations. Unequal allocations can be entered on the Beneficiaries page on www.ally.com or by calling us. For
additional beneficiaries, copy the following page and submit with the application.
When you add a beneficiary you must choose a beneficiary classification of individual, non-profit or charity, or other. Expanded FDIC coverage may apply
to individuals, non-profits and charities. Upon your death, Ally Bank pays your named beneficiaries based on your account ownership; however, you should
know that “other” beneficiaries may have limited or no FDIC Insurance coverage. Consult www.fdic.gov for more information on FDIC coverage.
The FDIC has made updates to its regulatory requirements for paying deposit insurance in the event of a bank failure. To make sure you receive the maximum
benefit you're entitled to, you'll need to provide a valid Social Security number, Tax ID number or other valid identification for each of your beneficiaries.
2a2a2aThe FDIC has made updates to its regulatory requirements for paying deposit insurance in the event of a bank failure. To make sure you receive the maximum benet you're entitled to, you'll need to provide a valid Social Security number, Tax ID number or other valid identication for each of your beneciaries.
INDIVIDUAL / JOINT ACCOUNT APPLICATION
3
Ally Bank, Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT WWW.ALLY.COM
UPDATED 02/2020
SOCIAL SECURITY
IDENTIFICATION NUMBER
OR
Alien ID card
(Choose one)
Driver’s License
Passport Military ID
ISSUER ISSUE DATE EXPIRATION DATE
FIRST NAME
M.I.
LAST NAME / SUFFIX
DATE OF BIRTH
Individual Other
CITY
ZIP
STATE
ADDRESS (NO PO BOXES)
SOCIAL SECURITY
IDENTIFICATION NUMBER
OR
Alien ID card
(Choose one)
Driver’s License
Passport Military ID
ISSUER ISSUE DATE EXPIRATION DATE
FIRST NAME
M.I.
LAST NAME / SUFFIX
DATE OF BIRTH
Individual Other
CITY
ZIP
STATE
ADDRESS (NO PO BOXES)
The FDIC has made updates to its regulatory requirements for paying deposit insurance in the event of a bank failure. To make sure you receive the maximum benet you're entitled to, you'll need to provide a valid Social Security number, Tax ID number or other valid identication for each of your beneciaries.
INDIVIDUAL / JOINT ACCOUNT APPLICATION
3
Ally Bank, Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT WWW.ALLY.COM
UPDATED 02/2020
SOCIAL SECURITY
IDENTIFICATION NUMBER
OR
Alien ID card
(Choose one)
Driver’s License
Passport Military ID
ISSUER ISSUE DATE EXPIRATION DATE
FIRST NAME
M.I.
LAST NAME / SUFFIX
DATE OF BIRTH
Individual Other
CITY
ZIP
STATE
ADDRESS (NO PO BOXES)
SOCIAL SECURITY
IDENTIFICATION NUMBER
OR
Alien ID card
(Choose one)
Driver’s License
Passport Military ID
ISSUER ISSUE DATE EXPIRATION DATE
FIRST NAME
M.I.
LAST NAME / SUFFIX
DATE OF BIRTH
Individual Other
CITY
ZIP
STATE
ADDRESS (NO PO BOXES)
The FDIC has made updates to its regulatory requirements for paying deposit insurance in the event of a bank failure. To make sure you receive the maximum benet you're entitled to, you'll need to provide a valid Social Security number, Tax ID number or other valid identication for each of your beneciaries.
4
INDIVIDUAL / JOINT ACCOUNT APPLICATION
Additional Services
Account Agreement
Fund Account(s)
By signing below, you agree that if you use and do not close your account within 30 days of opening, it will constitute your agreement to the terms of
the Ally Bank Deposit Agreement that will be sent to you after your account is opened. You authorize us to obtain a consumer report from a consumer
reporting agency to verify information provided in this application or for any legitimate business purpose in connection with the Ally Bank account.
DATE DATE
Debit Card:
Acceptance of Terms and Conditions
Overdraft Service
Check Order:
If you are a NEW customer:
If you are an EXISTING customer:
FINANCIAL INSTITUTION NAME
ACCOUNT NUMBER
ROUTING/ABA NUMBER ACCOUNT NUMBER
Yes Yes
Yes
Yes
Yes
Interest CheckingInterest Checking
Money Market Savings Money Market Savings
No No
No
No
No
Enclosed is a check with my application
Enclosed is a check with my application
Use funds from an existing Ally Interest Checking, Money Market Account, or Online Savings Account on which I am the signer
Initiate an ACH Transfer from a previously registered non-Ally account:
I authorize Ally Bank to initiate a one-time ACH debit to the following account
You may change or cancel the ACH transfer by calling us at 877-247-2559, unless the transfer status is “In Process” or “Complete.”
• Ally Bank is unable to accept cash deposits, foreign checks/currency, or savings bonds.
• Ally Bank is unable to accept cash deposits, foreign checks/currency, or savings bonds.
Complete and sign the attached if you currently have no existing accounts at Ally.
A
Ally Bank, Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT WWW.ALLY.COM
The statement for this account will be mailed to the address on file for the primary account owner. If you need to set-up online banking
credentials or want to view your statement online, contact us once the account is opened or visit us at www.ally.com.
Online Access and Statements
UPDATED 02/2020
This service links an Ally Money Market or Online Savings account to your Ally Interest Checking account. Refer to the Ally Bank Deposit Agreement
for a full explanation of this service and applicable fees that may be incurred.
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4
CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER
Backup Withholding Instructions
avoid backup withholding.
because you have failed to report all interest and dividends on your tax return.
A.
B.
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
3. I am a U.S. citizen or other U.S. person (including a U.S. Resident Alien), and
4. I am exempt from Foreign Account Tax Compliance Act Reporting.
SOCIAL SECURITY NUMBER OR EMPLOYER IDENTIFICATION NUMBER:
CUSTOMER SIGNATURE NAME DATE
CUSTOMER NUMBER (INTERNAL USE ONLY)
Ally Bank, Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT WWW.ALLY.COM
UPDATED 02/2020
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signature
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4
CERTIFICATION OF TAXPAYER IDENTIFICATION NUMBER
Backup Withholding Instructions
avoid backup withholding.
because you have failed to report all interest and dividends on your tax return.
A.
B.
Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has
3. I am a U.S. citizen or other U.S. person (including a U.S. Resident Alien), and
4. I am exempt from Foreign Account Tax Compliance Act Reporting.
SOCIAL SECURITY NUMBER OR EMPLOYER IDENTIFICATION NUMBER:
CUSTOMER SIGNATURE NAME DATE
CUSTOMER NUMBER (INTERNAL USE ONLY)
Ally Bank, Member FDIC
QUESTIONS? CALL 1-877-247-2559 OR VISIT WWW.ALLY.COM
UPDATED 02/2020
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Completed 30 July 2020

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