Application Questions To Be Filled Out & Returned
Business Information
Legal Name
*
(Include LLC or INC) and DBA
Business Address
*
Years in Business
*
EIN/Federal Tax ID Number
*
Best Customer Service Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Best Contact Full Name
*
Best Business Email (for customers)
*
example@example.com
Website/URL For Your Business
*
Parameters
Anticipated average sale amount
*
Anticipated highest sale amount
*
Anticipated monthly volume in
*
Signer Information
Legal First & Last Name
*
Title & Ownership %
*
Social Security Number
*
Date Of Birth
*
/
Month
/
Day
Year
Date
Driver's License Number
*
Driver's License Expiration Date
*
/
Month
/
Day
Year
Date
Driver's License State
*
Please Select
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Residential Address
*
Signer Information
Bank Name
*
Routing Number
*
Account Number
*
Back
Next
01. Check Or Bank Letter
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
02. Color Copy Of Signer's Driver's License
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
03. 3 Months' Most Recent Bank Statement
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
04. Articles of INC/Organization
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
05. COAs For Each Product
*
Browse Files
Drag and drop files here
Choose a file
must be on the site as well
Cancel
of
06. Proof of Domain Ownership
*
Browse Files
Drag and drop files here
Choose a file
screenshot showing URL & owner
Cancel
of
07. Product Sheet Required
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
08. 3 Months' Most Recent Processing Statement
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Preview PDF
Submit
Should be Empty: