Online Merchant Account Application

Application

First Name

Last Name

Email

Best Contact Phone/Mobile Number

What type of processing do you need?

Legal Business Name

“Doing Business As” (DBA) Name

Industry

How Will Your Business Accept Payments

Select A Shopping Cart / eCommerce Platform

Expected Monthly Volume

Average Transaction Size

Maximum Transaction Size

Has Your Company Had An Active Merchant Account In The Last 90 Days?

Current or Recent Merchant Account Provider

Business Background

URL

Date Business Opened

Federal Tax Id

Entity Type

SIC Code

Banking Information for Deposits

Bank Name

Routing Number

Account Number

Business Address

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Business Location

Primary Business Owner

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Phone/Mobile

Birthdate

Social Security Number

Approximate % Owned By Listed Owner

Underwriting Required Supporting Documents

Please submit 3 months of banking/credit card statements, a voided check, a Federal Tax ID, and a Business License/ Articles of Incorporation. Or you can email all supporting documents to [email protected].

File Upload

Choose File

Online Merchant Application