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Merchant Application
Business Information
Do you currently have a U.S. Bank Business Deposit Account?
*
Yes
No
Full DBA Name
*
Legal Name
*
Ownership Type
*
C Corporation Private
C Corporation Public
S Corporation
Limited Liability Company
Sole Proprietorship
General Partnership
Limited Partnership
Government
Tax Identification #
*
Employer Identification #
Country of Formation
*
ex: United States, Canada, Aruba etc.
Description of Products or Services
*
ex: CPA, Grocery, Retail Store, Contractor, HVAC etc.
Length of Ownership (Years)
*
ex: 1 yr, 2 yrs, 3 yrs, 10 yrs etc.
Length of Ownership (Months)
*
ex: 1 month, 2 months, 4 months, 12 months etc.
Year Business Established
*
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
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1959
1958
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1956
1955
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1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
Current Merchant Processor
Please Select
Authorize.net
Bank of America
Chase Paymentech
Citi Merchant Services
Clover
Cynergy Data
Fifth Third
First Data
Heartland Payment Services
Paypal
Square
Stripe
Square
Venmo
Wells Fargo
WorldPay/FIS
Other
Business Address
NOTE: Business Contact Phone Number will print of customer facing receipts.
Primary Contact
*
First Name
Last Name
Business Phone
*
Business Email
*
ex: name@email.com
Business Street Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Shipping Address (Optional)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Principal Information
Name and Residential Address
Primary Contact
*
First Name
Last Name
Mobile Phone
*
Note: U.S. Bank is requesting your mobile phone number to help us service your account.
Email
*
Note: U.S. Bank is requesting your email address to help us service your account.
Primary Owner Residential Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Responsible Party
*
Yes
No
Ownership Percentage %
*
Percentage %
Principal Title
*
ex: President, CEO, Owner etc.
Country of Citizenship
*
ex: United States, Canada, Aruba
Financial Information
Company Annual Revenue
*
ex: $1,234,456
Projected Monthly Card Sales
*
ex: $34,456
Average Transaction Amount
*
ex: $1,456
Highest Average Ticket
*
ex: $12,456
Frequency of Highest Average Ticket
*
Number of times per year. example: 10
Card Acceptance Split
*
Please Select
Card Present: 100%
Card Not Present: 100%
Internet: 100%
Omni Commerce
Business Website URL (optional)
www.samplewebsite.com
Customer Service Phone # (optional)
Delayed Delivery (optional)
How many days does it take for the cardholder to receive their product or completed service?
Seasonal Months Closed (optional)
January
February
March
April
May
June
July
August
September
October
November
December
Notes and Documents (Articles of Incorporation)
Per policy DO NOT upload ANY copies of any personal identification documents. (ex. U.S. State Driver’s License, Mexican Matricula Card, Social Security Card, U.S. Passport, U.S. State ID.
File Upload for Articles of Incorporation
Browse Files
Drag and drop files here
Choose a file
File Upload for Articles of Incorporation
Cancel
of
Merchant Statement
File Upload for 1 (one) current month of Merchant Statement from current processor.
Browse Files
Drag and drop files here
Choose a file
File Upload for 1 (one) current month of merchant credit card processing statement.
Cancel
of
This section is only to provide additional information to the credit underwriting team.
Notes
Submit
Should be Empty: