Congrats, you've been approved for a $25/month account!

Let's do this. Fill out the form below to instantly activate your Entrepreneur account at Dibz!

Date
Company
Primary Account Holder *

First Name Last Name
Email *
Phone Number *
Address *

Street Address

Street Address Line 2

City State

Zip Code
Bank Account Info *
Bank Account Type
Routing Number
Account Number
Name on Account
Bank Name
Alternate Dropoff / Pickup Persons (Up to 3)
Allow Dibz to auto-draft your bank account each month in the amount of $25? *

I authorize Dibz, Inc. to initiate debit entries to my account held at the financial institution indicated above. I acknowledge that the origination of ACH transactions to my account must comply with U.S. law and NACHA Rules.
Agree to receive notifications?

Yes, I agree to receive emails. Yes, I agree to receive texts.
Agree to terms & conditions? *

Yes, I agree.
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