DEPOSITOR COMPLIANCE APPLICATION Ancillary Services ... › wp...Jan 11, 2018 · Banking & Finance...

Banking & Finance Insiders

Cannabis Banking Specialists

Disclaimer The information in this document is intended solely for the benefit of firms, trusts and individuals seeking to be connected with financial information including, Funding and Monetization sources, PPP (Private Placement Programs) and Cannabis-friendly Funds Programs. Material provided by Fusion Bank may list possible service features and / or sample institutions for informational purposes only. None are guaranteed and all are subject to change on a daily basis. Nothing in this document constitutes an offer or solicitation to purchase any investment, solution or a recommendation to buy or sell securities nor is it to be construed as investment advice. The services provided by Fusion Bank may not be available in all jurisdictions or to all persons/entities. We select our clients carefully and do not accept all applications. Due to FATCA (Foreign Account Tax Compliance Act) we RESERVE THE RIGHT NOT TO provide ANY services to US Passport Holders, US Companies, US Trusts, clients utilizing Banks located in the US for transactions, or Clients that Reside in the US, or Businesses with Head Offices located in the US. You acknowledge that Fusion Bank has advised you that all transactions have risk, and that prior to entering any transaction all clients should undertake to consult Independent Legal and Accounting Experts prior to commencing, signing or committing to any transaction. Our Business is neither a Mutual Fund, Broker, Finance Company, Financial Adviser or Licensed in any way except as that provided via the Bahamas Friendly Society with which we are associated. We hereby advise all clients that any contemplated transaction(s) of our Clients are strictly private and in no way relate nor does involves the sale of registered public securities. All transaction information is strictly private, confidential and classified and not to be provided to parties not approved in writing by Fusion Bank nor published or referred to in any public forum on the internet or in the media. Disclosure, copying, distribution, reprinting or reuse of the contents or information in the form or on our web site is completely and totally prohibited.

- Strictly Private and Confidential -

© Copyright Fusion Bank, a Bahamas Friendly Society Members-Only licensed financial institution 2018 / All Rights Reserved

Web: https://www.FusionBank.US / Email: [email protected]

DEPOSITOR COMPLIANCE APPLICATION Ancillary Services Account Program

We conduct a thorough Due Diligence on all Applications to Verify you meet our High Standards for Consideration of Acceptance.

Submission of this application does not guarantee acceptance.

IMPORTANT: COMPLETE FORM & DELIVER INFORMATION ELECTRONICALLY IN PDF FORMAT TO: [email protected]

- Strictly Private and Confidential - Copyright Fusion Bank, a Bahamas Friendly Society Members-Only licensed financial institution 2018 / All Rights Reserved

Dear Potential Depositor, Thank you for your interest and application to the world’s first cannabis-friendly bank, Fusion Bank. From its inception, our company has operated solely as a dedicated cannabis-friendly organization. Fusion Bank emphasizes a strong and consistent message, “To Work Exclusively with State-licensed, City-permitted Medical Cannabis Operators.” Our mission is to legally and ethically provide the most economically beneficial bank services possible for growers of medical cannabis products and related cannabis operations. Our executive team consists of banking, finance and real estate industry professionals who have over 35 years’ experience in the financial instruments departments of top world banks, financial institutions and REITS. Our group consists of seasoned real estate experts, bankers, commodity traders and acquisition specialists. Throughout our company's history our management executives have consistently secured exceptionally large financial transactions across multiple industries. However, our business model is not dependent on volume or size of transaction but by the quality, security and safety of a transaction with a client. Our unique banking solution is in strict compliance with all required government and central banking regulations. Therefore, vetting and reporting is labor-intensive, which makes these accounts costly for the bank and our clients. Membership fees for a basic account can run from $1,900 to $10,000 per month or more, depending on the specific circumstances; this is a cost of doing business in the cannabis industry. The following explains the solution we provide and the bank account structure for which you are applying. In order to apply for a bank account, you must have first joined and become a Basic Member of the Bank. You will be issued a membership number, which you will include as part of this application. If, as and when your account application is approved, we provide a unique solution for Ancillary Service Provider Accounts from Cannabis operators as follows: Ancillary Service Providers are those entities or persons who provide support to the legal MMJ community, but who are not directly licensed as cannabis operators. This account is designed for service providers who have found it difficult to obtain “normalized” banking because they provide services to the legal MMJ and/or HEMP industry.


FEE STRUCTURE

• Ancillary Service Provider - Bank Account Application Fee Structure:

• Non-Refundable Application Fee: $499 USD • One-time Account setup and Compliance audit fee for each separate business or location

requiring separate accounts. All sites will be billed a quarterly audit to be quoted based on the type of business and fee collected in advance of onsite site inspection and examination.

• Ancillary Service Provider - Bank Account Fee Structure: • Minimum Account Balance: $1,000 USD • Account Opening Fee: 0.35% of the account balance, deducted from the account upon

confirmation of account opening. • Monthly Account Recurring Compliance Fee: After the initial account opening, a

recurring monthly compliance fee of 0.35% of additional monthly deposits with a minimum monthly account compliance fee of $12.00 USD will be charged if a balance of $1,000 is not maintained.

• Account Compliance fee will be charged to the client based on all funds deposited i.e. Check Deposits, Inbound ACH, Wires, and cash pickup including third party deposits.

• Cash Transport - Fee Structure:

• Armored Courier Fee: Variable based upon mileage and other factors. To be quoted by courier.

• Per pickup fee and mileage charge from pickup location to deposit location. All fees, terms and conditions insurance and bonding for these services will be provided to the client directly by National Cash Logistics Group within a separate agreement.

Yours sincerely, Application Committee Cannabis-friendly members-only banking by Fusion Bank Bank Referral Agent: I, ______________________________________________________hereby declare with full personal and corporate knowledge that the following Bank Referral Agent was responsible for introducing me to Fusion Bank and I am fully aware that said Bank Referral Agent is being paid a commission by Fusion Bank pursuant to a separate Referral Agreement between the Agent and Fusion Bank. Bank Referral Agent: _____________________________________________________, Signed: __________________________________________ Date__________________________

Correct Document Completion: Electronic Photos of Clients Initials and Signature should be inserted into this document. Text initials and Signature are not accepted.

Disclaimer: This document is provided in Microsoft Word Format for ease of the client’s completion. Under no circumstances are the clauses or contents in this document to be removed or deleted. Any client who is found to have removed or deleted clauses in this document will immediately have their transaction

cancelled and will be deemed to have committed fraud with appropriate penalties being imposed on them.

PDFescapeSticky NotePrint, sign and return OR return without signing and we will load your completed document and send to you to sign electronically


1. PROGRAM CONFIRMATION

I __________________________________ residing at Street:_________________________________________ City:_______________________________ State: _________Country: __________________________________

hereby confirm the following:

A. Program Confirmation

I would like to apply for enrollment and acceptance into the Fusion Bank Members-only Private Banking with the following Cash, Bank and/or Letter of Credit Funds:

The amount of Cash, Bank and/or Letter of Credit Funds is: __________________________________________________________

The Cash, Bank and/or Letter of Credit Funds Currency is Euro USD GBP Other ______________Specify

B. Funds Location

Cash, Bank and/or Letter of Credit Funds are in Vault Account Number:

___________________________________________ at:

Vault Name: __________________________________________ Vault Address: ________________________________________________________________________ Vault City: ________________________________ Vault Country:_______________________________

C. Funds Origin

I confirm the funds were legally earned from non-criminal origins, they are under my ownership or control and were historically earned from the following activities: _____________________________________________________________________________________

I, ________________________________________, hereby declare with full personal and corporate responsibility under penalty of perjury that the information given here is true and correct, genuine and accurate. By: ______________________________________________ Signed: __________________________________________ Date________________ Title: ______________________________ Passport Number: _________________________

Membership Number: _______________________________



2. ELIGIBILITY DECLARATION I __________________________________residing at Street: ________________________________________ City:______________________________ State: _________ Country: __________________________________

hereby confirm the following:

We DO NOT provide ANY services to Passport holders, Trusts or Businesses from the following countries:

• Afghanistan • Libya • North Korea • Sudan • Syria • Yemen

I, __________________________________________, hereby declare with full personal and corporate responsibility under penalty of perjury that the information given here is true and correct, genuine and accurate and I am not in any of the categories or groups listed above. I, __________________________________________, hereby declare with full personal and corporate responsibility under penalty of perjury that I comply with all compliance guidelines applicable in my jurisdiction, including but not limited to the Cole Memorandum regarding enforcement of laws regarding cannabis. Department of Justice. (2013, August 29). I, __________________________________________, hereby declare with full personal and corporate responsibility under penalty of perjury that I comply with all compliance guidelines applicable in my jurisdiction, including but not limited to the 2014 Guidelines published by the Financial Crimes Enforcement Network (FinCEN), in coordination with the U.S. Department of Justice (DOJ). I, __________________________________________, hereby declare with full personal and corporate responsibility under penalty of perjury that I comply with all compliance guidelines applicable in my jurisdiction, including but not limited to the FBAR and FATCA Requirements to Report of Foreign Bank and Financial Accounts, that must be filed both with the Financial Crimes Enforcement Network (FinCEN), which is a bureau of the Treasury Department and the IRS. By: __________________________________________, Signed:____________________________________________ Date_______________ Title: ________________________________ Passport Number: __________________________



3. CLIENT INFORMATION SHEET In accordance with Articles 2 through 5 of the Due Diligence Convention and the Federal Banking Commission Circular of December 1998, and under the US Patriot Act of 2002, as amended in February 2003 concerning the prevention of money laundering and 305 of the Swiss Criminal Code and Anti Money Laundering Act, the following information may be supplied to banks and/or other financial institutions for purposes of verification of identity and activities of the Client described below, and the nature and origin of the funds which are to be utilized. The foregoing is subject to agreement by all parties to whom this information is provided that they are obligated to respect the privacy rights of the Client and all individuals described herein, as well as the generally accepted professional standards relating to the maintenance of confidential information, and to take all appropriate precautions to protect the confidentiality of the information contained herein. This legal obligation shall remain in full force indefinitely without restriction.

BANK ACCOUNT APPLICATION

LEGAL BUSINESS INFORMATION

Sales Office Code: Agent Code: Date:

Legal Business Name: Phone:

Mailing Address: Website:

City: State: ZIP Code:

Tax ID:

Business type:

Corp LLC Non-Profit

Years in business:

DBA BUSINESS INFORMATION

DBA Business Name:

Physical address:


Website: Phone: Fax:

PRINCIPAL / CONTACT Owner Name:

Home Address: Phone:


Home Phone: Cell Phone: Email:

Percentage of ownership:

Authority to sign on behalf of the corporation?: YES NO

Date of birth:

SSN:

Are you a US Citizen: YES NO


Driver’s License or US Passport Number:

Issue Date: Expire Date:

LOCATION ADMIN CONTACTS Banking Admin: Phone: Email:

Cash Logistics Admin: Phone: Email:

BUSINESS REFERENCES Name Address Phone

BUSINESS / CASH MANAGEMENT INFORMATION

Did you have a bank relationship recently: YES NO

Bank Name: How long:

Average total cash deposits per month: When was it closed: Reason:

Do you currently pay staff with cash: YES NO Are you paying taxes with cash: YES NO

Are you behind on tax payments with the state: YES NO Are you paying penalties for using cash: YES NO

Do you use a payroll service for employees: YES NO Do you offer payroll cards: YES NO

How many vendors do you pay each month: Do they accept one or all of these payment types:

CASH CHECK ACH WIRE

Do you employ any type of vendor or compliance training: YES NO Does your state require training: YES NO

Do you require cash pickups? DAILY WEEKLY MONTHLY Estimated Pickup Amount:

Will you have initial funds to deposit into bank YES NO How much:

Will you have any checks, cashiers or certified checks to clear the bank: YES NO How much:

MEDICAL / RECREATIONAL CANNABIS STORE INFORMATION

(complete section if it applies to your business type)

Do you also service medical clients: YES NO % medical sales: % recreational sales:

Do you have active state license(s): YES NO Do you have active local License(s): YES NO

How many customers to you service daily: Busiest day of week: Busiest time of day:

Average customer sale amount: Do you have limits on purchases of product per customer:

Average purchase volume per client per week: Average purchase volume per client per month:


Are you seasonal? YES NO If Yes - Does, the volume drop in any specific months? If so which month(s):

Have you ever been cited for non-compliance?

YES NO If so, when and why?

Do you conduct employee training? YES NO If so, what program(s)?

Do you perform “mystery shopping”? YES NO Do you have Standard Operating Procedures? YES NO

Describe your daily procedures when a new customer comes in to make a purchase:

POS SYSTEM INFORMATION

(complete section if it applies to your business type) Name of current Seed-to-Sale POS Provider:

Any prior POS system used for historical records?

System Name and Version:

Contact phone:

Email:

Is your POS certified to track seed-to-sale: YES NO

If Medical: is POS HIPPA compliant: YES NO

You will be required to provide us direct access to your nightly POS reports to monitor inventory and sales activity for purposes

of reconciling deposited funds against sales activity. You will also be required to provide quarterly and annual sales and income

tax returns. Accept: YES NO

GROWER/CULTIVATOR/OTHER INFORMATION (complete section if it applies to your business type)

Business Type: GROWER CULTIVATOR Other:

How many locations to you have: How many square feet are managed: Number of plants:

Do you own facility real estate: YES NO Do you lease facilities: YES NO Lease term:

Are you doing regular Cannabis testing: YES NO Can you provide documentation if needed: YES NO

How are your products transported and or delivered?

Do you collect signed invoices for each purchase: YES NO Do you archive all sales information onsite: YES NO

Average quantity (units) or weight sold per transaction: Total quantity (units) and weight sold per month:


Average number of transactions per month per client: Average purchase amount per sale:

Have you ever been cited for non-compliance? If so, when and why?

Describe your procedures when a customer places wholesale order (steps and information collected):

COMPLIANCE INFORMATION

(All business types to complete this section)

Do you employ in-house compliance officer: YES NO Do you engage a 3rd party compliance group: YES NO

If yes, what group or compliance company do you use: Contact name:

Has any staff or principals completed state regulated compliance certifications: YES NO Certification type:

Has an auditor and or compliance group performed onsite audit: YES NO Date completed:

Do you have any documentation to provide: YES NO How often do you perform compliance audit:

Have you been cited for non-compliance:

YES NO

Do you have SOPs or other Compliance Documentation:

YES NO Please describe your compliance processes and procedures and how you manage compliance between all facilities:


AUTHORIZATION / SIGNATURES I authorize the verification of the information provided on this form and hereby give my consent and permission to use this information to qualify for a business banking account. I am aware that my application does not guarantee acceptance and approval. I also agree to all fees listed within this application and understand that the standard banking fees will apply. I also understand that Fusion Bank may request additional information as to my identity and or other business information to ensure full compliance with the federal and state laws and regulations. All applicants are subject to a full background check and OFAC report. I affirm that the funds to be processed are from legal sources. I also affirm that the funds managed by providers are supported by appropriate documentation and that company follows all AML policies as per the law. (Two signers are required if primary signer is less than 51% ownership)

Signature: Name: Date:





4. DECLARATION OF NON SOLICITATION AND FUNDS OWNERSHIP

I, __________________________________________, warrant and attest, with full personal and corporate responsibility that as the beneficial owner; I have full legal title and authority with no governing restrictions over the herein described Cash, Bank and/or Letter of Credit Funds. We hereby grant THE TRANSACTING PRINCIPALS and/or FUSION full permission and authority to verify, confirm, and reconfirm said collateral and/or assets on a bank-to-bank basis and conduct standard background checks of the collateral and/or assets, and the corporate entity owning such. I warrant and attest that I have not authorized or offered to any other party, consultant, broker or investor the placement of the collateral and/or assets defined herein nor have I shopped the collateral and/or assets to any other financial broker, consultant or company in the last 8 weeks. I certify and attest that at no time has your organization or any agent and / or appointee on your behalf made any offer or solicitation. I, __________________________________________, attest and warrant with full responsibility under the penalty of perjury that:

a) The available Cash, Bank and/or Letter of Credit Funds listed in this Application are from good, clean,

cleared sources, free and clear of security interests or similar interests of any kind or nature whatsoever. b) I or the company / trust I act for are the full owner, beneficiary or power of attorney of the Cash, Bank

and/or Letter of Credit Funds. c) The Cash, Bank and/or Letter of Credit Funds have been legitimately earned and obtained from non-

criminal & non-terrorist origins. d) The Cash, Bank and/or Letter of Credit Funds are free and clear of any liens or encumbrances and the

Cash, Bank and/or Letter of Credit Funds are under my control, immediately available and can be internally blocked without consent of any third party.

e) The Cash, Bank and/or Letter of Credit Funds are legally earned, taxed, and include no independent third-party interests.

f) The Cash, Bank and/or Letter of Credit Funds owner, beneficiary or power of attorney is not a party to a law suit or pending adverse legal action, further, there are no pending contracts existing, or about to exist, that could affect the said Cash, Bank and/or Letter of Credit Funds.

g) All information supplied in the documentation submitted with this Application and the Cash, Bank and/or Letter of Credit Funds involved, are not in violation of the Patriot Act of October 26, 2001, and amendments thereto, with its related financial crimes counterparts however interpreted, defined and enacted, whether within the United States or any other international jurisdiction.

I, __________________________________________, as Account Holder and duly Authorized Signatory, do hereby confirm that I have requested of you and your organization, specific confidential information and documentation on behalf of myself regarding currently available Private Banking Opportunities to serve only my interest, education, and not for further distribution. I hereby agree that all information received from you is in direct response to my request, and is not in any way considered or intended to be a solicitation of any sort, or any type of offering, and for my general knowledge only. I hereby affirm under penalty of perjury, that I have requested this information from you and your organization of my choice and free will and further, and that you have not solicited me in any way.


I hereby represent that I am not an informant, nor am I associated with any government agency of the United States of America, or any other country, such as the Secret Service, Internal Revenue Service, Federal Bureau of Investigation, Central Intelligence Agency, Securities and Exchange Commission, Banking Commission, Interpol, any countries Financial Market Authority, nor any agency whose purpose is to gather information regarding such transactions or offerings. I understand that any contemplated transaction is strictly one of a private nature, and is in no way relying upon, or relating to, the United States Securities Act of 1933, as amended, or related regulations, and does not involve the sale of public securities. Further, I hereby declare that you have disclosed that you are not a licensed security trader, attorney, certified public accountant or financial planner. Any information, work or service conducted hereunder is that of a private membership organization and that this is a members-only banking transaction that is exempt from the Securities Act and not intended for the general public but Private Members Use only. I acknowledge that submission of this application is no guarantee of acceptance, that no reason for being declined needs to be given, nor do I have a right to appeal any decision. I agree that regardless of the outcome with my application I will not to make any negative public or private statement either in writing or verbally to any other party, website, media company or person. The electronic or facsimile transmission of these documents shall be considered a binding and enforceable instrument, treated as original copy. Original may be obtained upon request. I, __________________________________________, hereby declare with full personal and corporate responsibility under penalty of perjury that the information given within this application true and correct, genuine and accurate, that I have had the opportunity to consult appropriate professional accounting and legal advice and that I have read and voluntarily agree to all statements in this documentation without reservation or hesitation. By: __________________________________________, Signed:____________________________________________ Date_________________ Title:_________________________________ Passport Number ___________________________



5. BOARD OF DIRECTORS / TRUSTEES CORPORATE RESOLUTION

A special meeting of the Board of Directors/Trustees of (Company/Trust Name) __________________________, (hereinafter referred to as “Corporation”) was duly held in accordance with the Articles of Association/By Laws of the Corporation on the ______ Day of ______________________, 2018, Present at the meeting were the following Directors / Trustees: ___________________________________________________________________________________________ The meeting of the Directors / Trustees undertook the following Corporate Resolution, which has been recorded in the Minute of the Book of the Corporation / Trust. It was unanimously resolved to utilize the Bank and/or Letter of Credit Funds with a value of ___________________________________________ on deposit at (Bank Name)_________________________) for an Internal Block Bank and/or Letter of Credit Funds Program. Additionally it was unanimously resolved, that (Authorized Persons’ Name) _____________________________, of the Corporation / Trust who is the authorized signatory of the Bank and/or Letter of Credit Funds, is authorized to use the full companies / trusts corporate authority, to enter into the Fusion Bank Cannabis-Friendly Banking Program, additional documents and fee agreements as necessary, to make the evaluation of these Bank and/or Letter of Credit Funds so as to assure the anticipated best fit for this Members-Only bank account. The necessary authority and powers required to undertake these tasks and responsibilities are hereby granted to: Name :__________________________________________________ Passport No. :__________________________________________________ Country of Origin :__________________________________________________ It is therefore, unanimously resolved that the appointed officer / trustee above shall have the authority to negotiate all details and sign the final contract with the officer representing the Bank and/or Letter of Credit Funds Program and associated authorities or bank officers. There being no further business, the meeting was declared adjourned, and in witness thereof, the directors signed below on the date first written above. Signed and sealed this date of ______/_______/2018 Signature:_______________________________ Full Legal Name:______________________________ Title:__________________________________ Passport # :_________________________ Passport Issuing Country:_____________________________



6. PASSPORT

Insert Full Color Photo of your Passport Here

I, __________________________________________, hereby declare with full personal and corporate responsibility under penalty of perjury that the passport above is mine and is true and correct, genuine and accurate. By: __________________________________________, Signed____________________________________________ Date_____/_____/_____ Title_________________________________ Passport Number ___________________



7. PICTURE OF THE VAULTED CASH, COPY THE BANK AND/OR LETTER OF CREDIT FUNDS BANK STATEMENT (Must be Less than 7 Days Old)

Insert Full Color Photo of your Cash (with a current newspaper in the photo showing a date within the last 7 days), Bank and/or Letter

of Credit Funds Bank Statement.

Must be Good Clear Photo and NOT Sanitized with Information Obstructed or Hidden Must be signed by two (2) Bank Officers

I, __________________________________________, hereby declare with full personal and corporate responsibility under penalty of perjury that the Bank and/or Letter of Credit Funds above is true and correct, genuine and accurate as of the date I have signed this declaration. By: __________________________________________, Signed:____________________________________________ Date_____/_____/_____ Title_________________________________ Passport Number ___________________



8. NON-SOLICITATION, NON-CIRCUMVENTION, NON-DISCLOSURE, NON-DISPARAGEMENT & PRIVATE BANKING AGREEMENT

PARTIES AND PURPOSE The undersigned are potentially and mutually desirous of doing business with respect to the arranging a private banking relationship in cooperation with one another and with specific agreements for the mutual benefit of all. It is their intention that the information exchanged among the signatories in the course of doing business, as well as the documents which will be generated subsequent to the execution of this Agreement, including but not limited to Buyers, Financers and Sellers identity, their websites or any electronic information and data, letters of intent, full corporate offers, bank comfort letters, contract terms and conditions, project plans and details, business and finance plans, financial and banking details or pre-advised payment instruments, and/or any information contained in such documents, will not be passed, under any circumstance, to another intermediary or broker or trader of any other company or private person who is not an end buyer or end supplier, without prior specific written consent of the party or parties generating or without proprietary rights to such information and/or documentation. This Agreement shall obligate the undersigned parties and their partners, associates, employers, employees, affiliates, subsidiaries, parent companies, nominees, representatives, successors, clients and assigns (hereinafter collectively referred to as ‘The Parties’) jointly, severally, mutually and reciprocally for the term of and to the performance of the terms and conditions expressly stated and agreed to below. Furthermore, whenever this Agreement shall be referenced in any subsequent document(s) or written agreements, the terms and conditions of the Agreement shall apply as noted and shall further extend to any exchange of information, written, oral or in any other form, involving financial data, personal or corporate names, contracts initiated by or involving the parties and any addition, renewal, extension, rollover amendment, renegotiations or new agreement that are in any way a component of what shall hereinafter be referred to as ‘The Project’ or ‘The Transaction’. NOW, THEREFORE, IT IS MUTUALLY AGREED AGREEMENT NOT TO DEAL WITHOUT CONSENT The Parties hereby legally, wholly and irrevocably bind themselves and guarantee to one another that they shall not directly or indirectly interfere with, circumvent or attempt to circumvent, avoid, by-pass or obviate each other’s interest, or the interest or relationship between The Parties, by means of any procedures, sellers, buyers, consultants, dealers, distributors, refiners, shippers, financial instructions, technology owners or manufacturers, for the purpose of changing, increasing or avoiding, directly or indirectly, payments of established or to be established fees, commissions, or the continuance of pre-established relationships, or to intervene in un-contracted relationships with manufacturers or technology owners, intermediaries, entrepreneurs, legal counsel, or to initiate and buy/sell or any transactional relationship that by-passes one of The Parties in favor of any other individual or entity, in connection with the subject Transaction or Project or any related future Transaction or Project. RELATIONSHIPS AND PREVIOUS RELATIONSHIPS If either Party has already established a previous relationship with the parties to a transaction or the contract introduced in the specific transaction, the Party with the previous relationship or transaction will immediately notify the other Parties by email or fax outlining the prior relationship and in that specific case, the Party with the previous relationship or transaction will be exempt from the non-circumvention clause of this Agreement. The other Party reserves it abilities and right to dispute the existence of prior relationship. Furthermore, The Parties agree that this Agreement shall not be construed to impede the development of normal day to day business relationships regardless of the existence of a pre-existing relationship on the part of either Party, such as, other direct seller’s portfolios and including but not limited to lenders and other mortgage brokers. AGREEMENT NOT TO DISCLOSE The Parties irrevocably agree that they shall not disclose or otherwise reveal directly or indirectly to any unauthorized individual or entity any confidential information provided by one party to another, including but not limited to contract terms, product information or manufacturing processes, prices, fees, financial agreements, schedules and information concerning the identity of sellers, producers, buyers, lenders, borrowers, consultants distributors, refiners, manufacturers, technology owners, or the representatives of any of the above, as well as names, addresses, principals or telex/fax/telephone numbers, references to product or technology information and/or any other information deemed confidential or privileged within the broadest possible scope of The Project or The Transaction without prior specific written consent of the party or parties generating or with proprietary rights to such information. AGREEMENT TO HONOR COMMISSIONS The Commissions will be paid between the Parties to this agreement as agreed to for each separate and individual transaction which will be detailed in a separate written Agreement. Commissions shall be paid through the designated paymaster, at the close of the transaction. All Parties herein unconditionally agree and guarantee to honor and respect all such irrevocable fee agreements.


AGREEMENT TO INFORM In the specific situation where a Party acting as an agent of the parties to this agreement or a buyer’s representative and any associated parties to this the seller to deal directly with one another, said Party 2 in this agreement shall be informed of the subsequent development of all transactions between the buyer or the buyer’s representative, and shall be provided timely copies of all pertinent developmental and/or transactional correspondence and documentation relative thereto by the buyer or the buyer’s representative and/or the seller. NON DISPARAGEMENT Party 1 agrees to act with Privacy and Confidentiality by protecting the personal and professional reputation of Party 2 by agreeing that, neither it nor any of its Affiliates, employees, investors, family, friends or Associates will directly, indirectly or anonymously, in any capacity or manner, make, express, transmit speak, write, verbalize or otherwise communicate in any way (or cause, further, assist, solicit, encourage, support or participate in any of the foregoing) including web sites, media, or social media, any remark, comment, message, information, declaration, communication or other statement of any kind, whether verbal, in writing, electronically transferred or otherwise, that might reasonably be construed to be derogatory, disparaging, critical of, or negative toward Party 2 or any of its directors, officers, affiliates, subsidiaries, employees, agents or representatives or any party associated with any transaction being facilitated by Party 2. In the event Party 1 breaches this Non Disparagement Clause, Party 2 is immediately and automatically to be awarded liquidated damages of $1,000,000 (One Million) USD for each proven public disparaging statement and $500,000 (Five Hundred Thousand Dollars) USD for each proven private disparaging statement and Party 2 will have the full legal right to pursue any and all legal remedies against Party 1 including court action to enforce this clause and collect any liquidated damages amounts owed by Party 1. Nothing in this clause shall prevent any person from testifying when subpoenaed or required by law by a Government Agency. TERM This Agreement shall be for ten years commencing from the date of this Agreement. This Agreement may be renewed for an additional ten years, subject to and upon the terms and conditions mutually agreed between and among the signatories. The Parties agree not to make contact with, solicit, deal with, or otherwise to be involved in any transaction(s) with regard to source, contact, trust, strategic partner and/or any other entity that the other Party introduces to or discusses with the other Party for a period of 18 months after termination of this Agreement. The term may be extended automatically if the Project is not closed during that time. This Agreement shall apply to: All transactions originated during the term of this Agreement; and all subsequent transactions that are follow up, repeat, or extended transactions or renegotiation(s) of transactions originated during the terms of this Agreement. Each Transaction shall be registered by the parties or their representatives and a record maintained of Date, Party, project and results and sent to all parties as it changes. This agreement supersedes any prior agreement. INJUNCTIVE RELIEF AND PENALTIES The Parties agree that in the event there is a violation of this Agreement, the Non-Violating Party is entitled to immediate injunctive relief as awarded or instructed by an Arbitrator under the terms of the Arbitration clause in this agreement. Furthermore, any violation of this Agreement is enforceable by a penalty of actual damages, per incident and such penalty shall apply to any and all subsequent transactions with that source, contact, trust, client, strategic partner and/or other entity. This penalty shall survive the term of this Agreement and all extensions and rollovers. AGREEMENT NOT TO CIRCUMVENT The Parties agree not to circumvent or attempt to circumvent this agreement in an effort to gain fees, commissions, remunerations or considerations to the benefit of the one or more of The Parties with the full knowledge and acquiescence of all necessary Parties, whether or not such fees, commissions remunerations or considerations gained through circumvention would otherwise be deemed the rightful property of any one or several of The Parties. ARBITRATION All disputes arising out of or in connection with this Agreement with the exception of the Non Disparagement Clause shall be fully and finally resolved by arbitration in accordance with the appointment of one professional Arbitrator in the country of the Bahamas as decided by Party 2. All such arbitration awards shall be binding on all Parties and enforceable by law. Party A in this agreement consents willingly to waive all rights to engage in any legal action in any court in any jurisdiction and agrees that any and all disputes between the parties with the exception of the Non Disparagement Clause will be resolved solely by way of Arbitration. The Parties further agree to carry out the terms of any arbitration award without delay and shall be deemed to have waived their right to any form of alternative recourse in court by or through any other means, in so far as such waiver can validly be made. Each of Parties named in an Arbitration proceeding and/or required to appear under such a proceeding, unless otherwise agreed, shall be responsible for its own legal expenses. The prior sentence notwithstanding, any Party adjudged by the Arbitrator to be in material breach of this Agreement shall compensate in full the aggrieved party, it's heirs assignees and/or assigns, for the total remuneration received as a result of business conducted with the Parties covered by this Agreement, plus, subject to the determination of the Arbitrator reasonable arbitration costs, legal expenses, and other charges and damages incurred relative to its dealings with banks, lending institutions, corporations, organizations, individuals, lenders, or borrowers, buyers or sellers that were introduced by the aggrieved party, notwithstanding any other provisions of the awarded. FORCE MAJEURE


Each of the Parties shall not be considered or adjudged to be in violation of this Agreement when the violation is due to circumstances beyond its reasonable control, including but not limited to Acts of God, natural disasters, civil disturbances, war, fire, floods, strikes and failure of third parties to perform their obligations to either Party. As a condition to the claim of no-liability the party experiencing the difficulty shall give the other prompt written notice, with full details following the occurrence of the cause. PRIVATE BANKING Each of the Parties agree and acknowledge that this application and agreement is solely and exclusively for the purpose of opening a Private Banking account, with all associated online banking services, including a debit card to be issued and associated with this account as well as Online bill pay, Mobile banking, Account alerts, and Online card activation. This account does NOT include any Merchant Services. Merchant Service accounts, including any credit card processing, are available through a separate application process and are not included as part of this Agreement. AGREED AND ATTESTED Each representative signs below guarantees that he/she is duly empowered by his/her respectively named company to enter into and be bound by the commitments and obligations contained herein either as an individual, corporate body or on behalf of a corporate body. NOTE: Initial, Date and Sign all pages in sequence including all parties representing the Party 1 and Party 2. Party 1: Company Name:___________________________________________________ Address: _________________________________________________________ Phone: ___________________________________________________________ Email: ___________________________________________________________ Signature:_______________________________ Date_____/____/____ Print Name & Company Position _________________________________________________________________ Party 2 Company Name: Fusion Bank Email: [email protected] Website: www.FusionBank.US Signature:____________________________________ Fusion Bank – CEO




9. ACCOUNT APPLICATION FEE, OPENING DEPOSIT, MINIMUM BALANCE & MONTHLY ACCOUNT COMPLIANCE FEE FOR PRIVATE BANKING

ACCOUNT APPLICATION FEE The undersigned understands, agrees and submits with this application a non-refundable account application fee in the amount of $499.00 USD. The payment of this fee does NOT guarantee acceptance or issuance of an account by the bank and is used solely to conduct the due diligence and complete banking compliance on the applicant. ACCOUNT OPENING DEPOSIT The undersigned understands, agrees and submits with this application a refundable account opening deposit in the amount of $______________________ USD. Said deposit shall be held in trust until the Depositor Review Committee reaches a decision. In the event the account application is denied by the DRC, then the opening deposit shall be refunded in full with no deduction or offset. No interest shall be earned or paid during the time when said deposit is held in trust. In the event the account application is approved by the DRC, then the opening deposit shall be transferred from the trust into the new bank account. ACCOUNT MINIMUM BALANCE The undersigned understands, agrees and confirms with this application that the account will be maintained with a non-depleting account minimum balance of $1,000.00 USD. Additional fees and costs will be applied in the event the account balance falls below $1,000.00 USD. ACCOUNT MONTHLY MAINTENANCE FEE The undersigned understands, agrees and confirms that should the Depositor Review Committee approve this application, it will be subject to a recurring minimum monthly account maintenance fee in the amount of $12.00 USD. This amount will be automatically deducted from the account each month only if the account balance falls below the minimum balance. ACCOUNT INTEREST AND WITHDRAWAL Account Balance Interest: For those accounts willing to deposit an account balance into Legacy Cash Accounts which are held for a minimum of twelve (12) months, there is interest paid on qualifying balances. Different interest rates apply to different terms. Accounts are not required to be interest bearing under term limits, however; all Accounts are restricted from any transfer or withdrawal during the first ninety (90) days. Withdrawal Limitations: You understand, agree and confirm with this agreement that an agreed upon amount of funds will remain in the account for a defined period of time (the “Term”) before being eligible for withdrawal. The Bank requires you to give seven days’ written notice to withdraw or transfer all or part of the balance of an account. Early Withdrawal of Principal: You are not permitted to withdraw a portion of your principal at any time prior to the agreed upon maturity date and in any event prior to ninety (90) days from account opening. You may withdraw the entire principal amount prior to maturity, but you will be charged an early withdrawal penalty. The principal, however, may be withdrawn prior to maturity without a penalty if you die or if there is a judicial or administrative determination that you are legally incompetent. Early Withdrawal Penalty: You are not permitted to withdraw a portion of your principal at any time prior to maturity. If you withdraw the entire principal amount from your Account prior to maturity, you will be charged an early withdrawal penalty based on the term of your account and the principal. The applicable early withdrawal penalties are as follows: Term Early Withdrawal Penalty Less than 12 months Ten (10%) percent simple interest penalty on the principal in the account 12 months to 5 years Twenty (20%) percent simple interest penalty on the principal in the account More than 5 years Thirty (30%) percent simple interest penalty on the principal in the account CLOSING OR RESTRICTING AN ACCOUNT We have the right to close or restrict any account at any time without notice and without your consent for any reason unless prohibited by applicable law. The following is a representative list, but not a complete list, of reasons we may restrict and/or close your Account:


• You provided incorrect or misleading information when opening your Account; • You are maintaining an overdrawn Account; • You are conducting or we suspect that you or a third party are conducting illegal or fraudulent activity; • Your account reaches a zero balance and remains at zero for sixty (60) days; • Your account is not funded within sixty (60) days of opening; • You fail to fund your account with the minimum balance within thirty (30) days of opening; • There is a dispute regarding your account; • We received a court order or other legal document prohibiting withdrawal; or • You abuse our systems or violate this Agreement.

If your account has a balance when we close it, we will return the funds to you minus any applicable penalty, unless prohibited by law, by ACH Transfer or wire transfer (with your authorization), or by mailing you a check. We may refuse to pay any debits or other items presented or re-presented for payment after your account is closed or restricted, but we are not obligated to refuse payment of those debits or other items, and we will not be liable for the payment of any debit or other item presented after your account is closed or restricted. Except as may be limited by applicable law, you agree to hold us harmless from and against any losses arising from, or in any way relating to, our refusal to pay or release funds in accordance with this section. INDEMNIFICATION AND LIMITATION OF LIABILITY You agree to indemnify and hold us harmless from any losses, damages, suits and expenses, including reasonable attorneys’ fees, which we may incur as a result of taking any action or not taking any action that we are entitled to take pursuant to this Agreement or relying upon instructions or information from you. EXCEPT AS OTHERWISE REQUIRED BY APPLICABLE LAW, WE ARE NOT LIABLE FOR ANY CLAIMS, COSTS, LOSSES, OR DAMAGES RESULTING DIRECTLY OR INDIRECTLY FROM OUR FAILURE TO ACT, OR ANY DELAY BEYOND TIME LIMITS PRESCRIBED BY LAW OR PERMITTED BY THIS AGREEMENT IF SUCH FAILURE OR DELAY IS CAUSED BY YOUR NEGLIGENCE, ACTS OR OMISSIONS OF THIRD PARTIES, INTERRUPTION OR MALFUNCTION OF EQUPMENT OR COMMUNICATION FACILITIES, SUSPENSION OF PAYMENTS BY ANOTHER FINANCIAL INSTITUTION, FIRE, NATURAL DISASTERS, ELEMENTS OF NATURE, GOVERNMENT ACTION, ACTS OF WAR, TERRORISM OR CIVIL STRIFE, EMERGENCY CONDITIONS, OR OTHER CIRCUMSTANCES BEYOND THE REASONABLE CONTROL OF THE BANK, PROVIDED THE BANK EXERCISED SUCH DILIGENCE AS THE CIRCUMSTANCES REQUIRE. EXCEPT AS OTHERWISE REQUIRED BY APPLICABLE LAW, THE BANK SHALL BE EXCUSED FROM SUCH FAILURE TO ACT OR DELAY AS LONG AS SUCH CIRCUMSTANCES PREVAIL AND THE BANK CONTINUES TO USE ITS COMMERCIALLY REASONALBE EFFORTS TO RECOMMENCE PERFORMANCE. EXCEPT AS OTHERWISE REQURIED BY APPLICABLE LAW, OUR LIABILITY TO YOU FOR A CLAIM IS LIMITED TO THE FACE VALUE OF THE ITEM OR TRANSACTION, OR THE ACTUAL VALUE OF ANY FUNDS NOT PROPERLY CREDITED OR DEBITED AND WE WILL NOT BE LIABLE FOR SPECIAL, IN ACCOUNT AUDIT AND COMPLIANCE The undersigned understands, agrees and confirms that should the Depositor Review Committee approve this application, it will be subject to a recurring account audit which will include confirmation of ongoing compliance by the account holder with respect to all permits, licenses, insurance, bonds and any other city, county, state or federal regulations applicable to the ongoing operations of the account holder. This account will not be subject to U.S. jurisdiction, will not be FDIC insured, will be protected by Society membership confidentiality and will be insured for the entire account balance by an internationally rated insurance provider. The undersigned applicant hereby confirms the following:

Account Application Fee & Opening Deposit Confirmation I would like to apply for enrollment and acceptance into the Fusion Bank Members-only banking with the following Application Fee and Opening Account Deposit, which is submitted along with this application in the combined amount of $_________________________________________ USD.

The Opening Deposit shall be paid by [ ] Wire Transfer / [ ] Cashier’s Check / [ ] Company Check / [ ] Cash.

I, __________________________________________, hereby declare with full personal and corporate responsibility under penalty of perjury that the information given here is true and correct, genuine and accurate. By: __________________________________________, Signed:____________________________________________ Date_____/_____/_____



10. ACH Recurring Payment Authorization Form Schedule your payment to be automatically deducted from your checking account. Just complete and sign this form to get started!

Fees collected from bank account established:

• 0.35% for all deposits; • $499 account application compliance review fee, non-refundable • $12 monthly minimum fee (charged if minimum balance of $1,000 not maintained) • All associated bank fees as well as 3rd party fees as shown on the above Fee Schedule.

Charges for deposits:

All clients who establish banking through Fusion Bank are subject to fees as described in the Fee Schedule. Any inbound deposits via ACH, Wire or deposited through vaulting services are subject to immediate debit from a bank account as per the client agreement.

Please complete the information below:

I __________________________________________, authorize Fusion Bank and or its assignees to charge my bank account as indicated within my Fee Schedule for all deposits made into my business checking account.

I understand and accept the fees and also know that the charges will be debited upon deposits made to my bank account established by Fusion Bank on my behalf. Each amount will not be the same and charges may vary based on deposits received and processed.

I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify Fusion Bank in writing of any changes in my account information or termination of this authorization at least 15 days before the next billing date. If the above noted periodic payment dates fall on a weekend or holiday, I understand that the payment may be executed on the next business day. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF) I understand that Fusion Bank may at its discretion attempt to process the charge again within 30 days, and agree to an additional $100 charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree not to dispute this recurring billing so long as the transactions correspond to the terms indicated in this authorization form.

Billing Address: Phone#:

City: _______________________________________________ State: ______________ Zip: _______________ Email:




11. Onsite Compliance Audit and Site Inspection Prior to establishment of your bank account, the bank or its authorized designees shall perform an onsite site inspection.

• The onsite inspector will only schedule appointments directly with principal signer(s). • Onsite audits can range between 1 -3 hours depending on the size of the facility.

o Typical retail dispensary audits are 90 min. o Combined business types Grower/Dispensary may take 120-180 min or more. o Information collected at location may include the following:

§ Interior and exterior walk through of business and supporting buildings. § Photos of the front, all sides, rear and inside of locations. § An example of auditor’s on-site review may include: POS system, video system,

disposal, medical testing, hardware backup systems, signage, secure access, employee procedures, client procedures, HIPPA compliance and more.

• After the onsite inspection is performed and all information complete the inspector will deliver their inspection report to the bank for approval or denial of service.

The Client can obtain a copy of the inspection report upon request.


12. Initial Compliance Documents

Mandatory documents needed

The checklist below lists the minimum number of documents that are required to establish services with compliance underwriting and banking providers. (Additional items may be requested)

Documents Required for initial account setup Checklist

Articles of Formation (Organization or Incorporation)

Copy of State Licensing Application Including Operating Agreement

Copy of Government ID or US Passport

City and state business license (if applicable)

State certificate of good standing (including all DBA’s and Trade Names)

State sales tax license

Most recent compliance Audit and Report (if applicable)

Current copy of Standard Operating Procedures (SOP)

Copies of Responsible Vendor/Compliance Training Certification (if applicable)

Vendor/Supplier contact information, contract(s), sample invoices (20%+ of expenses)

An inventory list with types of products sold, prices

History from the point of Sale Records (90 Days fully operational)

Balance Sheets, Cash Flow Statements, and Profit/Loss Statements (3 years)

Federal and State Tax returns (3 years or years available)

Provide a copy of all “management signatory’s badges issued from the state.”


13. Additional Compliance Documentation

***Upon Request Only *** Some or all of the information below may be required to facilitate banking and depository institution for clients. Unlike other options and or traditional banking our in-depth compliance systems and requirements allow for long-term, secure and fully compliant banking. Additional information may be requested as part of our review.

General Information Checklist Application and supporting documentation for licensure List of all owners and related parties (beginning with those with more than 25% equity and sub-entities) including names, personal address, percentage of ownership, relationship to the organization, citizenship, asset size, & annual income

Corporate leadership tree (showing titles and relationships)

Articles of Incorporation and By-laws

State filings and correspondence for the last twelve months Financial Information

Income Statements and Balance Sheets for the last twelve months (Excel format) Copies of audit(s) performed in the last twelve months Detailed monthly inventory report for last twelve months Daily sales records for the past 12 months Vendors

Any policies relating to vendor relationships List of all key vendors and contact info including location and what they provide Due diligence or salient information on current vendors All cash disbursements over $10k for the last twelve months Employees Employee training procedures Payment methods for employees (current and prospective) Employee screening process Miscellaneous

Procedures to ensure customers do not exceed the maximum daily purchase amount Expansion plans with prospective addresses or project volume if relevant Procedures to ensure no sales to minors Employee Handbook (if different from policies and procedures)

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DEPOSITOR COMPLIANCE APPLICATION Ancillary Services ... › wp...Jan 11, 2018 · Banking & Finance...

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