Personal Info

First Name *

Last Name *

Email *

Phone *

Address *

City *

State *

Postal code *

Date of birth *

Social Security # *

Business Info

Company *

Website *

Date Business Was Founded *

Business Type (LLC, S Corp, C Corp, Sole Prep) *

Federal EIN # *

Estimated Monthly Card Volume

Bank Routing # *

Bank Account # *

Refund Policy

Additional Info (Services needed, Terminals, Software, Etc.)

Attachments

Please upload all applicable items.

Drivers License

Voided Check or Bank Letter

Merchant Statement

Business License or Articles of Incorporation

Misc Attachment 1

NOTE:

If your business needs $75,000 in monthly volume or more
the bank will require the following items below. If this does not apply to you, please disregard last 3 attachments.

2nd Merchant Statement (2 months prior)

1st Business Bank Statement (last months)

2nd Business Bank Statement (2 months prior)

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text or email messages from the business.