New Customer Setup
First Name
*
Last Name
*
Email
*
Are You a New or Existing Customer
I am a new customer
I am an existing customer
Business Street Address
*
Business Street Address 2
Business City
*
Business State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Business Zip Code
*
Business Legal Name
*
Doing Business As (DBA)
*
Business Phone Number
*
Date Company Started
*
-
Month
-
Day
Year
Federal Tax ID
*
Owner SSN
*
Owner Cell Phone Number
Preferred Contact Method
Please Select
Call
Text
Email
Business Type (What is Being Sold)
*
Please Select
Tobacco Shop
Restaurant
Deli/Quick Serve Restaurant
Online B2C
Online B2B
Online Hemp/Delta
Hemp Based Product Store
Hair/Nail Salon
Retail/Store Card Present
Grocery/Convenience Store
Liquor Store
Other
Select Service That Best Applies To You
Please Select
Credit Card Processing
Credit Card Processing Zero Rate (Cash Discount Program)
NRS POS w/ Card Processing
Point of Sale - Information Needed
Average Monthly Credit Card Sales
*
Average Ticket Amount
*
what a customer typically spends per visit
Highest Ticket Amount
*
Current Processor
URL
Latest Time of the Day Your Business Closes
*
Hour Minutes
AM
PM
AM/PM Option
Maverick Person You Are Working With
First Name
Last Name
Voided Check
*
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Drivers License
*
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of
FNS Letter - REQUIRED for merchants access EBT SNAP
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EIN Letter from IRS, or Business License – NRS POS ORDERS ONLY
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Additional Comments or Questions You May Have
Please verify that you are human
*
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