Credit Technologies
Merchant Onboarding Form
Please review the Enrollment Application and the Merchant Agreements provided below. Once reviewed continue by clicking "Next" to fill the Enrollment Application electronically.
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BUSINESS INFORMATION
Name of Business
*
Federal Tax ID/EIN
*
Organization Type
*
Sole Proprietor
Limited Liability Company
Limited Liability Partnership
Corp
Partnership
State Organized
*
DBA
If applicable
Date of Incorporation
*
Publicly Traded?
*
No
Yes
Business Address
*
Mailing Address
Street Address Line 2
City
State
Zip
Business Phone
*
Business Fax
If not applicable type: N/A
Number of Locations
*
Buisness Website
*
Merchant Email
*
Services/Products Offered
*
IE: Med Spa, Medical Device, Medical Services
Financing Vertical
Powersports
Marine
Average Cost of Product/Service
*
Estimated Annual Sales
*
Estimated Annual Finance Volume
*
Has the Company Ever Declared Bankruptcy?
*
Yes
No
If Yes, When?
PRINCIPAL INFORMATION
Principal 1 First Name
*
Principal 1 Last Name
*
Principal 1 Social Security Number (SSN)
*
Principal 1 Date of Birth (DOB)
*
-
Month
-
Day
Year
Date
Principal 1 Position
*
Please Select
Operator
Member
Owner
Ownership %
*
Principal 1 Home Address
*
Home Address
Street Address Line 2
City
State
Zip
Principal Phone
*
Principal 1 E-mail
*
COMPANY CONTACT
Contact Name
*
Contact Title
*
Contact Phone
*
Contact Email
*
Banking Information
Depository Bank Name
*
Depository Bank Location
*
Routing/Transit Number
*
Account Number
*
Today's Date
*
-
Month
-
Day
Year
Date
Upload Voided Check or Letter Head from Bank (Can attach via DocuSign)
*
Browse Files
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Choose a file
Copy must be obtained to process onboarding
Cancel
of
Credit Authorization
The person signing below (the “Authorized Officer”) applies for and on behalf of Merchant to accept programs provided by Magwitch LLC (together with its successors and assigns, “Magwitch”) as contemplated by the Merchant Services Agreement previously received by Merchant having the same form number as this application (as amended from time to time, the “Agreement”). Authorized Officer agrees with Magwitch for and on behalf of Merchant that: (i) Merchant agrees to the terms and conditions of the Merchant Agreements which contains limitation of liability and (ii) the Agreement shall be effective and binding on Merchant if accepted by Magwitch. Authorized Officer certifies to Magwitch that all information contained in this application is true, accurate and complete (including the information for Beneficial Ownership and Controlling Party) and that he/she has authority to submit this application on behalf of Merchant. Merchant and Authorized Officer hereby authorize Magwitch to obtain, verify and exchange with any person or entity information about Merchant and Authorized Officer, including, without limitation, commercial and consumer credit reports. Merchant and Authorized Officer hereby authorize any person or entity to furnish Magwitch any information that such person or entity may have or obtain about Merchant and Authorized Officer. All of the above authorizations shall remain in effect until Magwitch rejects this application or, if Magwitch accepts the Agreement, until the Agreement is terminated and Merchant’s obligations under the Agreement are satisfied.
By providing your signature below you acknowledge that you have read the Merchant Agreement and understand that this signature will bind to the Merchant Agreement. By providing your signature below you confirm all the information provided is true to the best of your knowledge.
*
[This signature must match Principal (1) Name provided above] The executed agreement will be returned via email.
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