Get Approved!

Information you will need to fill this out.

Personal Information
• Full name, phone number, and email
• Social Security Number (SSN), date of birth, and equity ownership percentage
• Driver’s license number, issuing state, and a photo upload of the license
Business Details
• Legal business name and DBA (if applicable)
• Time in business and products/services offered
• Full business address, phone number, EIN, and website
Banking & Payment Processing
• Bank account name, routing number, and account number
• Upload of a voided check or signed bank letter
• Name of current payment processor
• Upload of previous month’s processing statement
• High ticket amount, average transaction size, and monthly processing volume
Supporting Documents
• Copy of driver’s license
• Company formation documents (Articles of Incorporation or similar)
• Last 2–3 months of business bank statements
• Last month’s merchant processing statement
Contact information
• Primary contact name and phone
• Referring person or company (if applicable)

First Name *

Last Name *

Phone *

Email *

Social Security Number *

Equity Ownership % *

Driver's License Number *

Issuing State *

Copy of your Drivers License (KYC check) *

Date of Birth (m/d/y) *

Legal Name of Business *

DBA

Time in Business *

Products Sold *

Address

Street Address

City

State

Postal code

Business Telephone *

Federal Tax ID (EIN) *

Bank Account Name *

Account Number *

Routing Number *

Contact Person Name *

Contact Telephone Number *

Website *

Monthly Volume *

Average Transaction Amount *

Current Provider *

High Ticket Amount *

Company Articles *

Copy of a Voided Check (or signed bank form) *

Referred By

Bank Statements for last 2-3 months *

Present Processor Statement for last two months (showing volume and amount per transactions) *

By checking the box, you agree to the following:

You consent to be contacted by our team via email, phone, or other communication methods provided in this form.
You agree to receive additional information about our credit card processing services.
You acknowledge that the information you provide is accurate and complete to the best of your knowledge.
You understand that your consent is required to proceed with the pre-application process.
I consent to receive transactional messages related to my account or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others.
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