Let’s Get Started!
Before you provide us with information about your business, please let us know which equipment you'd like.
Which Equipment Option Would You Like?
*
Clover Go
Clover Flex
Clover Mini
Clover Station Solo
Clover Station Duo
DejaVoo QD4
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This will only take another minute!
Tell us about your business.
Business Name (Doing Business As)
*
Business Phone Number
*
Business Email
*
Business Description
*
What products or services do you provide?
What's Your Average Sale Amount
*
Average purchase size by a customer in your business
What's The Largest Amount You'll Process In One Sale
*
Biggest sale size by a customer in your business
Legal Business Entity Name
*
This is the legal name of the LLC or Corp.
Business Entity Type
*
Please Select
LLC/LLP
Corporation
Sole Prop
Partnership
Govt. (Local/State/Federal)
Type of business
EIN # (Federal Tax ID)
*
This allows us to validate your business information
When Was The Legal Entity Formed
*
Estimated Monthly Credit Card Sales
*
Please Select
$2,500
$5,000
$10,000
$20,000
$30,000
$40,000
$50,000
$75,000
$100,000
$150,000
$200,000
$300,000
$400,000
$500,000
$750,000
$1,000,000
Estimated monthly credit card sales volume
Business Address
*
Street address
Suit, Unit, etc.
City
State
Zip Code
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Owner Information
Please fill out information about the owner
Owner Name
*
First Name
Last Name
Cell Phone
*
Title
*
Please Select
President
VP
Member
Owner
Date of Birth
*
-
Month
-
Day
Year
Business Ownership %
*
Your ownership share in this business
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
SSN # (Social Security Number)
*
This allows us to validate your information
Bank Name
*
This allows us to know where to deposit your funds.
Bank Account Number
*
This is where we will deposit credit card funds.
Bank Transit/Routing Number
*
This should be 9-digits long.
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