Getting Started

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Signer First Name

Signer Last Name

Signer Phone

Signer Email

Business Tax ID

Business Start Date

Number of Location

State of Formation

Legal Business Name

Corporate Legal Address

DBA

DBA Address

Mailing Name (if different)

Mailing Address

Website URL

Company Manager First Name (Could be owner)

Company Manager Last Name

Manager Contact Number

Manager Email

Ownership Information - Owner First Name

Owner Last Name

Ownership %

Date of Birth

Home Address

Owner Email Address

Owner Contact Number

Social Security Number

Business Name on Bank Account

Bank Routing Number

Bank Account Number

In-person Swipe/Terminal

In-person Keyed

By Mail/Telephone

eCommerce

Invoices

Recurring Billing

What percentage of monthly volume is recurring?

Consumer

Business

Government

Gross Annual Volume (all cards)

Total Monthly Volume (Anticipated for all cards)

Average Ticket (all cards)

High Ticket (all cards)

Annual Amex Volume

How long after charging the customer is the product fulfilled or does the service begin? (Use Cntrl / CMD for multiple selections)

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