Merchant Application

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Pre-Qualification Basic business details

Business Info Company details & contact

Principal Owner / signer information

Processing Volume & transaction details

Bank Details Settlement account

Documents Supporting files

Review & Submit Final confirmation

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Pre-Qualification

Let's start with the basics to determine eligibility and match you with the right processing program. This step takes about 60 seconds — nothing sensitive yet, and we email you a link so you can finish the rest whenever you're ready.

Legal Business Name *

Estimated Monthly Volume *

Processing Method *

Industry / MCC Code *

Current Processor

Business Email *

Business Phone *

Business Information

Tell us about your company. This helps us match you with the right processing program.

Legal Business Name *

DBA / Trade Name

Business Type *

Federal Tax ID (EIN) *

Business Address *

City *

State *

ZIP *

Business Phone *

Business Email *

Website

Year Founded

Industry / MCC Code *

Brief description of products/services *

Processing Method *

Principal Information

Federal regulations require all owners with 25%+ ownership to be listed. Add each owner below.

All personal data including SSN is encrypted with 256-bit SSL and never stored in plain text. Your information is protected and confidential.

Owner 1

100%

First Name *

Last Name *

Title *

Ownership % *

Date of Birth *

SSN *

Confirm SSN *

Driver's License # *

DL State *

DL Expiration *

Home Address *

City *

State *

ZIP *

Phone *

Email *

History Information

Have you or any principal filed bankruptcy? *

All individuals owning 25% or more of the business must be listed.

Processing Details

Help us understand your transaction volume and sales environment so we can structure the right account.

Monthly Card Volume ($) *

Average Ticket ($) *

Highest Ticket ($) *

Current Processor

Sales Environment

Must total 100% across the three boxes.

Card Present / Swipe %

Keyed / MOTO %

Internet / E-Com %

Total: 0%

Fulfillment

Must total 100% across same-day / 7-day / 14-day / over-14.

Same Day %

Within 7 Days %

Within 14 Days %

Over 14 Days %

Recurring Billing?

Total: 0%

Refund Policy *

Number of Locations

Chargeback History / Notes

Customer Type

Must total 100%

Individual %

Business %

Government %

Customer Location

Must total 100%

Local %

National %

International %

Fulfillment & Delivery

How long after charging is the product fulfilled or service begins? *

How long after the order does the cardholder receive the product/service? *

When is the cardholder charged? *

Do you have a retail location? If yes, provide the physical address

How do you advertise? (internet, social media, magazines, tv, etc.) *

Business Location

Tell us about the physical premises your business operates from.

Building Type *

Do you own or rent? *

Area Zoned *

Square Footage *

Bank & Settlement Details

Where should we deposit your funds? This is the account that will receive your daily or weekly settlements.

Bank Name *

Account Type *

Routing Number *

Account Number *

Confirm Account Number *

Account Holder Name *

Bank details are encrypted and transmitted securely. We never store full account numbers in plain text.

Supporting Documents

Photo ID, voided check, and bank statement are required for all applications. Processing statements (minimum 2 months) are required if you have existing processing history.

Your documents are encrypted with 256-bit SSL and stored securely. We never share your personal information with third parties.

Required Photo ID / Driver's License PDF, JPG, or PNG

Whose ID is this?

Required Voided Check PDF, JPG, or PNG

Required Bank Statement (3 mo) PDF, JPG, or PNG

Processing Statement (Month 1) PDF, JPG, or PNG

Processing Statement (Month 2) PDF, JPG, or PNG

Review & Submit

Review your application details below. You can click any section header to go back and edit.

Business Information

Principal

Processing Details

Bank Details

Documents

By submitting this application, you agree to our Privacy Policy and Terms of Service. Your data is encrypted with 256-bit SSL, stored securely, and never sold to third parties.

Start your approval.

Pre-Qualification

Business Information

Principal Information

Owner 1

Processing Details

Sales Environment

Fulfillment

Customer Type

Customer Location

Fulfillment & Delivery

Business Location

ACH Processing Details

Bank & Settlement Details

Supporting Documents

Review & Submit

Business Information

Principal

Processing Details

Bank Details

Documents

Application Submitted