WeProcess Application

Merchant Services Application
Your Funding Specialist is:
Agent Email
example@example.com
Business Information
Business Legal Name:*
DBA Name:*
Federal Tax ID #*
Enter Numbers Only
Industry Type
Type of Entity *
State Incorporated
Monthly Credit Card Transactions
Average Credit Card Transaction
Highest Credit Card Transaction
Business Start Date

MonthDayYear
Date
Business Phone #*
Business Address:*
City:*
State:*
Zip Code:*
Home Based Business

NoYes
How Many Owners?

12
Owner Information
First Name*
Enter Text Only
Last Name*
Enter Text Only
Cell Phone #*
Enter Numbers Only
Ownership %:
Enter Numbers Only
SSN:*
Date of Birth*

MonthDayYear
Home Address*
Email*
example@example.com
City:*
Enter Text Only
State:*
Zip Code:*
Owner 2 Information

If the Owner 2 signature field is left blank a separate email will be sent to their email for their signature.
First Name*
Enter Text Only
Last Name*
Enter Text Only
Cell Phone #*
Enter Numbers Only
SSN:
Enter Numbers Only
Ownership %:
Enter Numbers Only
Date of Birth

MonthDayYear
Home Address
Owner 2 Email Address*
example@example.com
City:
Enter Text Only
State 2:
Select From the Drop Down
Zip Code:
Enter Numbers Only
Do you own or rent your home?

OwnRent
Signature*

Clear
Owner 2 Signature

Clear
Merchant Email
example@example.com
Should be Empty: