Merchant Account Application

Business Information

Business Legal Name *

Business Start Date *

Business Type *

Tax ID/EIN *

Business Address *

City *

State *

ZIP Code *

First Name *

Last Name *

Email Address *

Phone Number *

Job Title *

Owner SSN *

Date of Birth *

Owner Percentage *

Average Transaction Amount ($) *

Estimated Monthly Volume ($) *

Bank Routing Number *

Bank Account Number *

Maximum file size: 5MB per file. Allowed types: PDF, DOC, DOCX, JPG, PNG, TXT

Articles of Incorporation/Organization *

Bank Statements (Last 3 months) * You can select multiple files

Principle Identification Front/Back *

Voided Check or Bank Letter *

Additional Documents (Optional) Any other supporting documents

Estimated Annual Processing Volume ($) *

Average Transaction Amount ($) *

Brief Business Description *

Website URL (if applicable)

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