Merchant Processing Solution Application

Business Information

Processing Options *

Merchant Processing Solutions

ACH Processing Solutions

ATM Solutions

Business Legal Name *

Business Address *

Business Phone Number *

Business Email Address *

Business Website *

Business EIN Number *

Business Start Date *

Percentage of Ownership *

Business Monthly Revenue *

MCC Code

Type of Goods or Services Sold *

Use of Funds *

Amount of Business Locations *

Business Formation *

Sole Proprietor

Partnership

LLC

Corporation ( C or S Corp )

Tax Exempt (501C) Nonprofit

Business Processing Type *

Card Present

Keyed

MOTO

Internet

E-commerce

Average Ticket Sale *

High Ticket Sale *

Business Owner Information

First Name *

Last Name *

Address *

Phone *

Email *

Date of birth *

Social Security Number *

Credit Rating *

Company Title *

Property Status *

Business Required Documents

Upload Required Documents (Check Box as you upload documents) *

Government State ID

3 Months Business Bank Statements

Articles of Incorporation

EIN IRS Letter

Voided Check

Required Business Documents Upload Here *

Required Business Documents Upload Here

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Business Opportunities Available For Sale

Are you interested *

YES

NO

Schedule Best Appointment Date

Business Opportunities Available For Sale

Schedule Best Appointment Time

Businesses For Sale By Industry

Business Owner Signature

Borrower Signature *

Clear

By checking this box I agree to apply for a Merchant Processing Solution through the Merchant Processing Solution market place and allow Empowerment Funds to START, SUBSCRIBE EMAIL - SMS - CALL Marketing list for Updates, Promotions, and more

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