Application

Application

Merchant Information

*If sole proprietor enter your first and last name only, otherwise enter legal company name here
*(Doing Business As) This will appear on cardholder's statements as the charge
*Please enter numbers only no spaces or dashes
Business Address
Business Address
City
State/Province
Zip/Postal

Owner Information

Home Address
Home Address
City
State/Province
Zip/Postal

Business Information

Currently processing credit card?
Have you ever had a credit card relationship terminated?

Bank Information

Upload Documents

We kindly request that you send the following documents:


1. Driver’s License Front and back
2. Articles of incorporation
3. Voided check/ Bank letter
4. EIN SS4 Form
5. SSN Front
6. 3 Month Processing Statements (If not Available, please provide 3-month personal Bank Statements)
7. Any other supporting documents, such as Reseller Agreements, Client Contracts, or Supplier Agreements.
8. Utility Bill.

Maximum file size: 2.1MB