New Merchant Enrollment

New Merchant Enrollment

Onboarding Form
Business Information
Name of Business
Federal Tax ID / EIN
Organization Type
Doing Business As (DBA)
Date of Incorporation (Secretary of State)

MonthDayYear
Is your business at least 2 years old?
Publicly Traded?
Business Address

Mailing Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Business Phone
Please enter a valid phone number.Format: (000) 000-0000.
Business Fax (If not applicable type: N/A)
Number of Locations
Business Website
Merchant Email
example@example.com
Merchant Type
Do you want to enroll into the Guaranteed Approval Program?
Estimated Annual Sales (e.g., $1,000,000)
Estimated Annual Finance Volume (e.g., $200,000)
Average Cost of Product/Service (e.g., $10,000)
Has the company ever declared bankruptcy?
If Yes, When?
Principal Information

This information must be filled correctly or enrollment cannot be processed. If you have questions on the following please reach out and inquire before submitting inaccurate information.
Principal 1 First Name
Principal 1 Last Name
Principal 1 Date of Birth (MM-DD-YYYY)

MonthDayYear
Date
Principal 1 Social Security Number (SSN)*
If this is not provided, Onboarding Cannot Proceed.
Principal 1 Position
Ownership Percentage (%)
Length of Ownership (Years)
Principal 1 Home Address (Must be the residential address or Principal 1)*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Principal Personal Phone
Please enter a valid phone number.Format: (000) 000-0000.
Principal 1 E-mail
example@example.com
Are there additional owners?
Company Contact for Financing

The Financing Contact
Contact Name
Contact Title
Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Contact Email
example@example.com
Portal Email
This email will be utilized for the Dealership login credentials - If not filled out: CONTACT's EMAIL ABOVE will be used
Banking Information
Depository Bank Name
Depository Bank Location
Routing / Transit Number
Account Number
Upload voided check or bank-issued ACH form (must show account & routing number ownership)

VOIDED CHECK OR BANK ISSUED ACH FORM ONLY - If anything other is provided, Onboarding can be delayed.
Cancelof

Certain participating Bank Partner(s) may require a direct agreement with Dealers. Below, you will find the required Merchant Agreement and Enrollment Application. Please review and download these documents for your records.

By clicking "I Agree" below, you:
- Confirm that you have read and understood each of the agreements.
- Agree to the terms and conditions set forth in each document.
- Acknowledge that your electronic signature will be applied to all agreements as if you were signing each document in person, with the same legal effect and enforceability.
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.
Today's Date

MonthDayYear
Date
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.*
Signature

[This signature must match Principal (1) Name provided above] The executed agreement will be returned via email.
Should be Empty:

New Merchant Enrollment

Business Information

Principal Information

Company Contact for Financing

Banking Information

Credit Authorization