Payment Processing Application

We are excited to work with your business. We pride ourselves in giving our clients a fantastic experience when working with our team. Please let us know if there is ever anything we can do to provide more value to your business. We are here to help! Below is the application for our payment processing. Please be sure to fill the information out correctly to the best of your knowledge to ensure a seamless experience and prompt approval. we look forward to working together!

Legal Business Name

Does This Business Have a DBA? (Fictitious Name)

Yes No

Business DBA/Fictional Name

Business Street Address

Business City

Business State

Business Zip

Business Email

Business Phone

Business Structure

Business Start Date

Business Tax ID/EIN

Does the Business Currently Have a Website?

Yes No

Business Website URL

Projected MONTHLY CC processing Volume

Average CC Transaction Amount

Highest CC Transaction Amount

Will Your Business be Taking ACH Payments? (Electronic Checks)

Yes No

Projected MONTHLY ACH processing Volume

Average ACH Transaction Amount

Highest ACH Transaction Amount

Business Bank Name

Account Number

Routing Number

Photo of a Voided Check or Bank Letter

Signer's First Name

Signer's Last Name

Signer's Email

Signer's Phone

Signer's Street Address

City

State

Zip

Signer's Date of Birth

Signer's Drivers License Number

Signer's Social Security Number

Signer's Drivers License Photo

Will There Be An Alternative Contact Person?

Yes No

Alternative Contact's Full Name

Alternative Contact's Phone

Alternative Contact's Email

Payment Processing Application

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Payment Processing Application

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Thank You for Submitting Your Payment Processing Application!