Certification Submission Form Certification Submission Form Financial Institution Name* Full name of your bank or credit union. Include your financial institution’s location if it is a common name. FDIC Certification #* Please enter your institution’s Cert # (if applicable) NCUA ID #* Applicable only to credit unions. If not applicable write N/A Total Deposits Please enter your institution’s total deposits on hand. Product Name* Please enter the anticipated product name as it would appear on consumer-facing materials Primary Contact* First Last Title Email Phone Product Specific URL* If a product specific webpage is not available, please provide your main website URL. Upload Terms and Conditions* Please upload account terms and conditions as well as any consumer-facing marketing materials, if any, related to the account. Drop files here or Select files Accepted file types: pdf, Max. file size: 35 MB, Max. files: 10. Who is your banking core processor? FinastraFISFiservJack HenryBMA BankriteCOCCCSODataCenterDataproFinxactInfosysIntellect Design ArenaMambuMoovNeocovaQ2SAPShazamSmileyTataTechnisysThought MachineUFSOther Please Enter the total number of U.S. branches* Branch Footprint* AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingPuerto RicoU.S Virgin Islands Select all the states where the bank or credit union has a branch presence. Hold crtl key to choose more than one. Can this account be opened online YesNoNot yet, but we are working on itNot Fully, but the process can be started onlineOther When do you anticipate this product will be publicly available?* If the account is already live, please select today’s date. If the product is still in development, please note anticipated launch date. MM slash DD slash YYYY Bank On Data Reporting The Federal Reserve Bank of St. Louis partners with the CFE Fund to collect and report data on certified Bank On accounts. Bank On National Data (BOND) Hub reports are published in aggregate keeping anonymous each financial institution’s individual data. Please provide a contact for us to reach out to with more information on this voluntary initiative. First Last Email Please share any additional information that might be useful CAPTCHA