SKEA Application

1
LOCATION OR DBA NAME* This field is required.Please enter the name of the Organization that is applying got the award.
2
Upload File
3
LEGAL NAME* This field is required.Please enter the name of the Organization that is applying for profile.
4
Email
example@example.com
5
Phone Number
Area Code
Phone Number
6
MANAGER OR OWNER
Please Select
Please Select
OWNER
MANAGER
7
TYPE OF BUSINESS
Please Select
Please Select
SOLE
LLC
C CORP
S CORP
LLP
PARTNERSHIP
8
NAME OF AUTHORIZED SIGNER
First Name
Last Name
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
10
Social Security number.* This field is required.Required because of the Patriot Act and Anti-Money Laundering Act
Section 326 of the USA PATRIOT Act requires financial institutions to verify and record information
11
DRIVERS LICENSETake out your ID and snap a quick picture and upload it.
12
VOIDED CHECK FOR DEPOSITTake out your check and snap a quick picture and upload it.
13
Signature* This field is required.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 $249.00 per month. 3. This is a 3-year month-to-month processing agreement. 4. NO CANCELLATION FEE 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 soft credit review to confirm business related identification. If you agree to this credit review, confirm your information by signing below
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