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| ID Verification Form

Section 1: Discover Bank Applicant or Customer Identify Verification Acknowledgement


To be completed by the Discover Bank applicant or customer

By signing this form in the presence of a licensed notary, you acknowledge that you applied for or have a deposit
account with Discover Bank and any information you provide will be used for verification.

Printed name as it appears on your application/account: ________________________________________________

Applicant/Customer Signature: _________________________________________ Toda s Date: ____ / ___/ _____

Best Contact Phone Number: ____________________________

Section 2: Identification Details


To be completed by the Bank Notary / U.S. Embassy Representative / Military Legal Office Representative
Instructions: Please document the applicant/customer s identification detail.

Type of ID: ________________________________________


Acceptable IDs include: U.S. Dri er s License, U.S. State ID, U.S. Visa, Passport, or other U.S./ U.S. State Government issued ID

Name as it appears on the ID: ____________________________________________________

ID Number: ___________________________________________________________________

State or Country of Issuance: _____________________________________________________

Issue Date: ____ / ___/ _____ Expiration Date: ____ / ___/ _____

Date of Birth: ____ / ___/ _____

Section 3: Notarizing Officer/Signature Guarantor Information & Stamp


Name of Notarizing Officer/Signature Guarantor: ______________________________________

Notary Commission/Identification Number: ___________________________________________

Name of Business/Other: _________________________________________________________

Street Address: _________________________________________________________________

City, State, & ZIP Code: __________________________________________________________

Direct Business Phone Line: _______________________________________________________

Notarizing Officer Signature: _______________________________________________________

Place Notary Stamp/Signature Guarantee Stamp below and/or attach any applicable documents
Note: If the individual resides in California, please provide a Signature Guarantee.

©2020 Discover Bank, Member FDIC

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