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    We are currently only accepting applications from Cortland, Cayuga, Madison, Oneida, Onondaga, and Oswego counties at this time.

    Please verify that you are a resident of Cortland, Cayuga, Madison, Oneida, Onondaga, or Oswego County, New York.

    OK Yes, I verify I am a resident. is required

Company Information

  • OK Name of Company is required
  • OK Business Legal Address (No P.O. Boxes) is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Mailing Address the same as Legal Address?

    OK Mailing Address the same as Legal Address? is required
  • OK Business Mailing Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Phone

    ( )
    OK Phone is required
  • OK Tax Payer ID # is required
  • OK Email Address is required
  • Business Structure

    OK Business Structure is required
  • OK Organized in the State of is required
  • OK How Long Established? is required
  • OK How Long Under Current Managment? is required
  • OK Nature of Business (Business or Service) is required
  • OK Annual Sales is required
  • OK Business Net Income is required
  • OK Business Net Worth is required
  • OK Number of Employees is required
  • Optional OK Affiliates / Subsidiaries is required

Owners / Guarantors

  • How many people will be issued this card to start?

    OK How many people will be issued this card to start? is required

Primary Card Holder

  • OK Name is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • OK Company Title is required
  • OK Percent of Ownership is required
  • Date of Birth

    OK Date of Birth is required
  • OK Mother's Maiden Name is required
  • OK Residential Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Primary/ Home Phone

    - -
    OK Primary/ Home Phone is required
  • OK Limit for this Individual Card is required

Secondary Card Holder

  • OK Name is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • OK Company Title is required
  • OK Percent of Ownership is required
  • Date of Birth

    OK Date of Birth is required
  • OK Mother's Maiden Name is required
  • OK Residential Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Primary/ Home Phone

    - -
    OK Primary/ Home Phone is required
  • OK Limit for this Individual Card is required

3rd Card Holder

  • OK Name is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • OK Company Title is required
  • OK Percent of Ownership is required
  • Date of Birth

    OK Date of Birth is required
  • OK Mother's Maiden Name is required
  • OK Residential Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Primary/ Home Phone

    - -
    OK Primary/ Home Phone is required
  • OK Limit for this Individual Card is required

4th Card Holder

  • OK Name is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • OK Company Title is required
  • OK Percent of Ownership is required
  • Date of Birth

    - -
    OK Date of Birth is required
  • OK Mother's Maiden Name is required
  • OK Residential Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Primary/ Home Phone

    - -
    OK Primary/ Home Phone is required
  • OK Limit for this Individual Card is required

Bank Information

  • OK Institution Name is required
  • OK Institution Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • OK Checking Account No. is required
  • OK Average Balance is required
  • OK Savings Account No. is required
  • OK Average Balance is required
  • Loans

    OK Loans is required
  • OK Total Balances is required
  • OK Total Payments is required

Security Code

  • OK is required
  • Solvay Bank reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, you grant full permission to do so.