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 Volume

Average Credit Card Transaction

Highest Credit Card Transaction

Business Start Date

Date

Business Phone #

Business Address:

City:

State:

Zip Code:

Home Based Business

How Many Owners?

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?

Signature

Owner 2 Signature

Merchant Email

example@example.com