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Contact Information

Please provide your basic contact details and let us know how you heard about us.

Personal Details
Contact Details
We'll use this email for communication and to send you a resume link.
How Did You Hear About Us?
Privacy Notice: Your contact information is secure and will only be used to process your application and communicate with you about our services.

Business Information

Tell us about your business, including company details and address information.

Company Details
If different from legal name
Select the date your business was established
Business Structure
Business Characteristics
Business Address
Mailing Address
Security Notice: All business information is encrypted and stored securely. We comply with all applicable data protection regulations.

Owners Information

Please provide information about all business owners. Each owner must have at least 25% ownership.

Total Ownership: 0%
Important: Owner information is required for credit verification and compliance purposes. All owners with 25% or more ownership must be included. All data is protected and used only for application processing.

Transaction Information

Tell us about your payment processing needs and transaction volumes.

Payment Processing
Transaction Volumes
$
Total monthly transaction volume in USD
Enter 0 if you don't use physical terminals
Processing Estimate: Based on your transaction volume, we'll provide competitive rates and custom solutions for your business needs.

Review & Submit Application

Please review your information and submit your secure application.

Contact Information
Name: Not provided
Email: Not provided
Phone: Not provided
Business Information
Company Name: Not provided
Tax ID: Not provided
Business Address: Not provided
Business Owners
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Transaction Information
Monthly Volume: Not provided
Accept Credit Cards: Not specified
Accept ACH: Not specified
Terms and Conditions

Please confirm that your business is not related to the following industries:

  • Cannabis dispensary
  • Guns and Ammunition
  • Adult entertainment
  • Illegal gambling
You must confirm your business is not in restricted industries.
You must accept the terms and conditions.
Electronic Signature

Electronic Signature Instructions:

Please sign in the box below using your mouse or touch device. Your signature will be securely stored.

Note: Click 'Clear' to start over if needed.

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Please provide your electronic signature above.
Secure Application Submission

Your application is transmitted using 256-bit SSL encryption and stored securely. Our team will review your application and contact you within 24-48 hours.

Next Steps: After submission, you'll receive a confirmation email and one of our representatives will contact you to discuss your payment processing needs.

Security Verification

Your information is protected by industry-standard security measures.

By clicking 'Submit Application', you confirm that all information provided is accurate and complete.