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Company: Tax Identification Info
Business Name
Must Match IRS Income Tax Filing
Federal Tax ID
Fill in with SS# if you do not have EIN
Business License
Fill in with SS# if you do not have EIN
Business License State
Fill in with SS# if you do not have EIN
Business Email
example@example.com
Website Address
www.mywebsite.com
Business Phone #
-
Area Code
Phone Number
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Company: DBA Info
Is DBA Address same as Legal Address
Yes
No
DBA Phone #
DBA Phone #
-
Area Code
Phone Number
DBA Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Company: Location Info
When was your business founded?
-
Month
-
Day
Year
Date
Have you (your business or any principal) filed bankruptcy?
Business Bankruptcy
Personal Bankruptcy
Never Filed
Type of Ownership
Sole Proprietor
Partnership
Corporation
LLC
Type of Business
Non-Profit
Tobacco/Vapes/E-Cig/E-Juice
Business Consulting/Advertising/Marketing
Business Opportunities
Seminars
Doc Prep
Web Design
Credit Repair
Tech Support
Adult
Construction/Greensky/Solar
Skin Care
Nutra/Supplements
Retail
Other
Approximate Size of Company Office
0 - 500 sq ft
501 - 2000 sq ft
2000+ sq ft
Company Office Zone
Residential
Commercial
Industrial
Number of Years at Location
Number of Months at Location
Number of Years of Ownership
Number of Months of Ownership
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Owner 1: Identification Info
Full Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Driver License #
Drivers License State
Drivers License Exp Date
Social Security #
Date of Birth
-
Month
-
Day
Year
Date
Ownership Percentage
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Owner 1: Address Info
Is Home Address same as Business Address
Yes
No
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of Years at Residence
Number of Months at Residence
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Owner 2: Identification Info
Full Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Driver License #
Drivers License State
Drivers License Exp Date
Social Security #
Date of Birth
-
Month
-
Day
Year
Date
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Owner 2: Address Info
Is Home Address same as Business Address
Yes
No
Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of Years at Residence
Number of Months at Residence
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File Upload
Upload a clear picture of your documents from your phone or upload documents from your computer
Estimated Average Monthly Volume
Estimated Average Ticket Amount
3 recent monthly bank statements
Browse Files
business preferred, if unavailable personal is accepted
Cancel
of
COA - Certificate of Analysis
Browse Files
CBD and THC products
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of
3 recent monthly processing statements (cash app, paypal, venmo etc. acceptable)
Browse Files
IF you don't have any please move to next section
Cancel
of
Voided Check
Browse Files
If you are LLC, business account check or bank letter is mandatory
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of
Articles of Organization
Browse Files
Cancel
of
Copy of Driver License
Browse Files
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of
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