Merchant Processing Application (MPA)

Business Information

Business Name (DBA) *

Business Phone Number *

Business Email *

Business Start Date

Business Location Type *

Select Business Type *

Legal Information

Business Type

Tax ID (EIN) *

Legal Name of Business *

Tax Filing Name

Business Address Information

Address *

Business Address

Business City

Business State

Business Zip Code

Ownership Information

Driver's License Front *

Upload Your Driver's License Here (Front only)

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF ( max 2 Files )

Ownership Percentage

Social Security Number

Owner's Phone Number (if different from Business #)

Owner's Email Address (if different from Business Email)

Owner's Title

Bank Information

Bank Name

Bank Account Type

Bank Account Usage Type

Account Number *

Routing Number *

Processing Information

Detailed explanation of the merchandise and/or services sold/performed

Average Monthly Card Volume

Average Ticket Amount

When is the Customer Charged?

After your customers pay, how long does it take for service to be complete?

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply. Text HELP to +1 916-740-7586 for help or STOP to opt-out.