ARCA - Merchant Services Signup Link -CD

Sign-Up Form

Merchant Services Agreement
🇺🇸 In English:

Before you begin, please ensure you have the necessary documents and information ready. You will need a copy of a voided check or bank letter, a copy of the signer's driver's license, and details such as Social Security Number and Date of Birth for all owners with 25% or more ownership. All information is collected and stored securely. Additionally, the agreement must be signed by an owner or a designated controlling individual. Having these ready will speed up your application.
🇧🇷 Em Português:

Antes de começar, certifique-se de ter os documentos e informações necessários em mãos. Você precisará de uma cópia de um cheque anulado ou carta bancária, uma cópia da carteira de motorista do signatário, e informações como número do Social Security (SSN) e data de nascimento de todos os proprietários com 25% ou mais de participação societária. Todas as informações são coletadas e armazenadas com segurança. Além disso, o acordo deve ser assinado por um proprietário ou por um indivíduo controlador designado. Ter esses documentos prontos agilizará sua aplicação.
Contact Name*

First NameLast Name
Title*
Contact Email*
example@example.com
Contact Phone Number*
Please enter a valid phone number.

Business Information
Business DBA (Doing Business As) Name*
Business Legal/Corporate Name*
Your Business Address (No P.O. Boxes)*

Street Address

Street Address Line 2

CityState

Zip Code
Your Business Billing/Corporate Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Business Phone Number*
Please enter a valid phone number.
Your Business Email*
example@example.com
Your Business Website*
Your Business Start Date*

MonthDayYear
Date
Products/Services Sold*
Your Business' Entity Type*

Limited Liability Company/LLCPrivate Corporation - Chapter S/CIndividual/Sole ProprietorshipTax Exempt Organization (501c)Public CorporationPartnership
State of Formation*
Name (as it appears on your income tax return)*
Federal Tax ID # (as it appears in your income tax return)*

Controlling Individual Information

Only applies to private corporations, limited liability corporations, or partnerships. An Individual with significant responsibility for managing the legal entity (e.g., a Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice President, or Treasurer).
Controlling Individual's Name

First NameMiddle InitialLast Name
Controlling Individual's Ownership Percentage
Controlling Individual's Title
Controlling Individual's Phone Number
Please enter a valid phone number.
Controlling Individual's Email
example@example.com
Controlling Individual's Home Address (No P.O. Boxes)

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Controlling Individual's Date of Birth

MonthDayYear
Date
Controlling Individual's Social Security Number
Ownership Information

Each Individual, who owns, directly or indirectly, 25% or more of the equity interests of the legal entity customer (e.g., each natural person that owns 25% or more of the shares of a corporation).
How Many Owners have 25% or More Ownership in the Business?
- First Owner's Name*
  
  First NameMiddle InitialLast Name
- First Owner's Ownership Percentage*
- First Owner's Title*
- First Owner's Phone Number*
  Please enter a valid phone number.
- First Owner's Email*
  example@example.com
- First Owner's Home Address (No P.O. Boxes) *
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- First Owner's Date of Birth*
  
  MonthDayYear
  Date
- First Owner's Social Security Number*
- Second Owner's Name
  
  First NameMiddle InitialLast Name
- Second Owner's Ownership Percentage
- Second Owner's Title
- Second Owner's Phone Number
  Please enter a valid phone number.
- Second Owner's Home Address (No P.O. Boxes)
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Second Owner's Date of Birth
  
  MonthDayYear
  Date
- Second Owner's Social Security Number
- Third Owner's Name
  
  First NameMiddle InitialLast Name
- Third Owner's Ownership Percentage
- Third Owner's Title
- Third Owner's Phone Number
  Please enter a valid phone number.
- Third Owner's Home Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Third Owner's Date of Birth
  
  MonthDayYear
  Date
- Third Owner's Social Security Number
- Fourth Owner's Name
  
  First NameMiddle InitialLast Name
- Fourth Owner's Ownership Percentage
- Fourth Owner's Title
- Fourth Owner's Phone Number
  Please enter a valid phone number.
- Fourth Owner's Home Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Fourth Owner's Date of Birth
  
  MonthDayYear
  Date
- Fourth Owner's Social Security Number

Equipment Desired
Equipment Desired*
Quantity Desired
Additional Equipment (if desired)
Leave Blank Unless Extra Equipment is Desired
Quantity Desired
Additional Equipment (if desired)
Leave Blank Unless Extra Equipment is Desired
Quantity Desired
Additional Equipment Needed (More than listed above)

YesNo

Additional Documents and Signature

Please review the agreement PDF before submitting. Partially completed or unsubmitted forms will not be recorded, and thus, the e-signature will be invalid. After submission, you can download a copy of the agreement, and a copy will also be emailed to you.
Additional Documentation

Voided Check or Bank Letter required. Starter checks will not be accepted. A bank letter must have a bank letterhead, the company's name, routing number, bank account number, and signature from a bank representative.
Voided Check or Bank Letter*

Cancelof
Photocopy of Driver's License*

Cancelof
Signature and Initials
Initial Here*

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Signature*

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Signing Date

MonthDayYear
Date
Cost 1
Cost 2
Cost 3
Total 1
Total 2
Total 3
Total Month
Total Cost (over 4 years)
Equipment Name 1
Equipment Name 2
Equipment Name 3
Should be Empty:

Sign-Up Form

🇺🇸 In English:

🇧🇷 Em Português:

Business Information

Controlling Individual Information

Ownership Information

Banking/Financial Information

Banking Information

Financial Information

Equipment Desired

Additional Documents and Signature

Additional Documentation

Signature and Initials