Elavon Account Application Form

Elavon Account Application Form

Hi, and welcome to the Elavon account application. In order to get started, we need to collect information regarding you and your business. This information will be collected and processed on behalf of your business towards Elavon Inc, where your payment processing account will be created.
Before you fill out this form

Before filling out this form, make sure you have access to documentation regarding your business, like proof of incorporation, sales information, information regarding owners (copy of passport or driver's license, address information etc) and bank account numbers. If you have any questions, reach out to your 360Player representative or payments@360player.com.
Company information

Please provide the basic details for your business.
Company legal name
Company "doing-business-as" name
Type of business
Employer Identification Number (EIN)
Business website
Business phone number
Please enter a valid phone number.Format: (000) 000-0000.
Business address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country of business formation

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Year of business establishment
Length of current ownership
Years and months
Industry type
Describe your business
Contact details
Contact name

First NameLast Name
Contact email
example@example.com
Contact phone number
Please enter a valid phone number.Format: (000) 000-0000.
Support contact details
Support email
example@example.com
Support phone number
Please enter a valid phone number.Format: (000) 000-0000.

Principal ownership

Details about the ownership structure and the owners of the business.
Amount of owners with more than 25% ownership?
How many principal owners do you have in your company?
Principal owner

Who is the main owner of the company? This is the person who will be the counterpart and sign all contracts on behalf of the business.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Percentage of ownership
If applicable
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth

MonthDayYear
US Citizen?
Social Security Number
This is required due to United States anti-money laundering regulations.
US Identification document

E.g driver's license
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Issuing country and state

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Identification document number
Issuing date

MonthDayYear
Date
Expiration date

MonthDayYear
Date
Principal owner #2

Who is the main owner of the company? This is the person who will be the counterpart in all contracts.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Percentage of ownership
If applicable
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth

MonthDayYear
US Citizen?
Social Security Number
This is required due to United States anti-money laundering regulations.
US Identification document

E.g driver's license
Cancelof
Issuing country and state

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Identification document number
Issuing date

MonthDayYear
Date
Expiration date

MonthDayYear
Date
Principal owner #3

Who is the main owner of the company? This is the person who will be the counterpart in all contracts.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Percentage of ownership
If applicable
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth

MonthDayYear
US Citizen?
Social Security Number
This is required due to United States anti-money laundering regulations.
US Identification document

E.g driver's license
Cancelof
Issuing country and state

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Identification document number
Issuing date

MonthDayYear
Date
Expiration date

MonthDayYear
Date
Principal owner #4

Who is the main owner of the company? This is the person who will be the counterpart in all contracts.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Percentage of ownership
If applicable
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth

MonthDayYear
US Citizen?
Social Security Number
This is required due to United States anti-money laundering regulations.
US Identification document

E.g driver's license
Cancelof
Issuing country and state

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Identification document number
Issuing date

MonthDayYear
Date
Expiration date

MonthDayYear
Date

Business metrics (AML requirements)

Information regarding your sales, required for anti-money laundering regulations.
Est. average sale amount
In USD - an estimation of how much your average sale is worth.
Est. monthly revenue
In USD. An estimation of the revenue you will have each month.
Est. high sale amount
In USD - an estimation of how much your highest sale would be worth.
Est. number of high sales annually
The number of the above stated above sale you are estimated to get during a year.
Annual revenue
In USD (answer with an estimation if you don't have the answer)

Bank account details

Please provide the bank account information regarding where payouts should be distributed.
Bank name
ABA / Routing number
DDA Account number

Documents

Please provide the documentation that you have access to below.
Proof of incorporation

Certified article of incorporation OR Signed operating agreement OR Government issued business license
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Financial statement. Please select if you want to sign a personal guarantee or send in a financial statement to verify your business.
Financial statement (most recent 3rd party audited)

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If available - 3 months of current processing statements

If your business is currently processing any transactions, this document is mandatory.
Cancelof
If tax exempt - Proof of tax exempt status (501-C3)

Cancelof
Please verify that you are human
Should be Empty:

Elavon Account Application Form

Before you fill out this form

Company information

Contact details

Principal ownership

Principal owner

Principal owner #2

Principal owner #3

Principal owner #4

Business metrics (AML requirements)

Bank account details

Documents