Cash Swipe: Fill Now/Sign Later

Complete and prepare the merchant agreement with the necessary information.

You fill out all the required fields and details now.

The final signature is added afterward; it must be sent from the processor's portal.

Sales Agent Name

PROCESSOR

Legal Name of Business

(As filed to the state)

DBA Name

(Storefront Name)

Legal Address

City

State

Zip

Phone Number

Area CodePhone Number

Email Address for Notices

example@example.com

Customer Service Phone Number

Area CodePhone Number

Length of Years the Business has been owned

Website Address

www.example.com

Is the DBA Address Different from Legal Address?

DBA Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Statements?

Chargebacks?

Products or services sold

Please provide a detailed response

Taxpayer Identification Number: Must be 9 digits (EIN or SSN)

EIN for Corporation or LLC / SSN for Sole Proprietorship

Taxpayer Identification Number

Legal Business Name (as shown on your income tax return)

(Must match Legal Name, confirm be reviewing you EIN Letter)

Type of Ownership

Full name of owner (as shown on ID)

Date of Birth

Date

SSN

Percent Owned (%)

U.S. Person Non-U.S. Person

Residential Address, City, State, Zip

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Please upload a copy of your ID

Title of person opening account

(Manager, Owner, President)

Average Credit/Debit Transaction Amount

Example: $30, $50, $150, etc. (full dollar amount only, no ranges)

Total Credit/Debit Monthly Sales

Example: $50,000 (full dollar amount only, no ranges)

Please provide a percentage of where the transaction method will take place. If E-commerce is selected, the business must have a website with a functioning shopping cart.

% of transactions Swiped/ In Person

1/3 Total of these three must equal 100 below

% of transactions key in Manually/ Phone

2/3 Total of these three must equal 100 below

% of transactions performed Online/Ecommerce

3/3 Total of these three must equal 100 below

Total Must Equal to 100%

Bank Name

Routing Number

Bank Account Number

Please upload a copy of a voided check to verify banking information

Voided Check or Bank letter signed by a banker must be provided. All other forms are not permitted
Valid identification: ID or Passport
Proof of Buisness may be required depeneding on the type of business or if the underwriter has any alerts regaring the legitamacy of the account.

- EIN Letter

-Business License

ITIN is not accepted under this processor. ITINs are a nine-digit number begining with a “9”

EBT: if the merchant wants to accept EBT Food a FNS letter must be provided.
High average tickets may be required to provide invoices, processing statements or bank statements.
Lease Agreement/ Utility Bill may be required if the Underwriter needs to verify the merchants home address.
Truepic: May be required if the Underwriter needs to verify the physical business location or inventory. A link will be sent to the phone number and email listed on the application.
Contractors will need to provide a copy of their Service Agreement or Contract issued to customers.
If the merchant is not in good standing with the Secretary of state the merchant will need to get back in good standing before the account is approved.
Hawk alerts must be removed
Credit Freeze must be lifted or it will delay the approval process
A hard credit check is ran.

Date

BUSINESS INFORMATION

W-9 INFORMATION

BENEFICIAL OWNER INFORMATION

CARD PROCESSING INFORMATION

BANKING INFORMATION

Disclaimers