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3-D MENU SET UP
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12
Questions
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Language
English (US)
Spanish (Latin America)
1
LOCATION OR DBA NAME
*
This field is required.
Please enter the name of the Organization that is applying got the award.
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2
LEGAL NAME
*
This field is required.
Please enter the name of the Organization that is applying for profile.
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3
Email
example@example.com
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4
Phone Number
Area Code
Phone Number
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5
MANAGER OR OWNER
Please Select
OWNER
MANAGER
Please Select
Please Select
OWNER
MANAGER
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6
TYPE OF BUSINESS
Please Select
SOLE
LLC
C CORP
S CORP
LLP
PARTNERSHIP
Please Select
Please Select
SOLE
LLC
C CORP
S CORP
LLP
PARTNERSHIP
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7
NAME OF AUTHORIZED SIGNER
First Name
Last Name
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8
SSN OF OWNER OR SIGNER(mgr)
*
This field is required.
Needed for Security and Identity purposes to comply with national digital financial transfer laws
Section 326 of the USA PATRIOT Act requires financial institutions to verify and record information
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9
FEDERAL TAX ID #
*
This field is required.
Federal business Tax ID number. (may be same as SSN depending on business size and type.
Section 326 of the USA PATRIOT Act requires financial institutions to verify and record information
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10
DRIVERS LICENSE
Take out your ID and snap a quick picture and upload it.
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11
VOIDED CHECK FOR DEPOSITS
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12
Signature
Agreement for Merchant Processing Services I agree to the following terms: 1. Zero fees for merchant processing integrated in Urhost Checkout software. 2. Service cost of $299.00 per month. 3. This is a 3-year month-to-month processing agreement. Credit Review Consent Your financial well-being is of utmost importance to us, and obtaining your consent for this review is crucial in helping us serve you better. Please be assured that any information gathered will be handled with the utmost confidentiality and used solely for the purpose of assessing your eligibility for certain financial products or services. By signing below, I confirm that I have read and understood the terms of this agreement and consent to a credit review. If you agree to this credit review, confirm your information by signing below
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