New Account Application

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Legal Name*
Doing Business Name*
Not your legal name, what people call your company.
Type Of Business*
Company Address*
Street Address Address Line 2 City State ZIP Code
Business Phone*
Type Of Ownership*
How do you accept payments?*
- Select All
- In Person
- Online
- Phone Orders
Customer Service Phone
If you have a different phone number for customers to call.
Contact Email*
Website
Age of Business
How long have you been operating?
If you know it, what's the month and year the company opened?
Employer Identification Number
EIN or TIN is given by the government for filing taxes.
Voided Check
Drop files here or
This can be done later, but the sooner we have it the faster the setup.
Average Monthly Transaction*
Average Monthly Sales*

Owner Or Officer Name*
First Last
Owner or Officer Title*
Owner or Officer Home Address*
Street Address Address Line 2 City State ZIP Code
Owner or Officer Phone*
Social Security Number*
Our site is secure, however, If you prefer to give this info over the phone, please give us a call.
Date of Birth
Our site is secure, however, If you prefer to give this info over the phone, please give us a call.

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