Please fill out the secure intake form below to apply for a merchant account.

Every question must be answered accurately and to the best of your ability. If you have any questions please call or text us at 727-732-3292 and we will help!

Business Details

Legal Entity or Legal Business Name *

PLEASE MAKE SURE THE LEGAL ENTITY PROVIDED MATCHES YOUR WHAT IS ON FILE WITH THE IRS

DBA *

(Doing Business As; Name of Business)

Tax ID # or EIN # *

Corporate Phone Number *

You must include country code before phone number. Please put "+1" for US phone numbers.

Type of Ownership *

Corporate Address *

PLEASE INCLUDE FULL STREET ADDRESS INCLUDING ANY SUIT, UNIT, OR APT NUMBERS

City *

State *

Postal/Zip Code *

Corporate Email *

Physical Address Same as Corporate Address?

Description of Product Sold *

Date Business Started *

If you have a website, please provide the URL below. If you don't have a website please provide a link to either a social media page or a google business listing. (OPTIONAL)

Do you sell Kava, Kratom, CBD, THC, Delta8, Hemp, or any products containing these ingredients? *

Processing Volume Details

Average Ticket *

What is your average sale amount?

Typical High-End Ticket *

What is the highest transaction amount you ran in the past 12 months? We want to provide the amount of the highest sale you anticipate occurring on a regular basis.

Average Monthly Card Processing Volume

How much do you typically process in card sales on average in a month/

% Card Swiped / EMV *

What percentage of your sales do you take card payments in person where the customer hands you a physical card to swipe, tap, or insert?

% Keyed (Card Not Present) *

What percentage of your sales do you take card payments over the phone, online, or electronically where the physical card is not present at the point/time of sale?

If you have not processed card payments yet, please enter estimated percentages (%) for each category.

These can be approximate.

Sum of both these MUST BE EQUAL to 100.

Do You Accept EBT or Food Stamps? *

Do you accept payment significantly in advance of delivering a product or performing a service? *

Future Delivery: Customers pay now but receive the product or service at a later date (such as deposits, pre-orders, hotel reservations, or contractor deposits). This does not include restaurants, takeout, or businesses that typically provide products or services immediately.

Auto or Manual Batch? *

Shipping Information

Is the Shipping Address Same as the Business Address

*REQUIRED IF ORDERING EQUIPMENT FROM US*

Business Banking Information (where do you want your funds deposited?)

Bank Account Number *

Routing Number *

PLEASE DOUBLE AND TRIPLE CHECK THE BANKING INFORMATION YOU PROVIDE IS CORRECT, AS THIS IS WHAT WILL BE USED ON THE MERCHANT APPLICATION

Upload a Voided Check or Bank Letter (optional, but recommended)

Not required in most cases.

Name of Bank *

Owner Information

Owner First Name *

Owner Last Name *

Owner Mobile Phone *

Owner Best Email *

Ownership %

Social Security Number *

May we run a credit check as part of underwriting? Declining is an option, but it may extend the time needed to approve the application and get the merchant account live. *

Owner Driver License *

Is your local residential address different from the address on your driver’s license? *

How did you find us? *

Required

By checking this box, I consent to receive non-marketing text messages from Tampa Bay Pay related to setting up and supporting my merchant account, including onboarding updates, account status, and support communications. Message frequency varies, message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

Texts and calls will come from 727-732-3292.

Optional but recommended

By checking this box, I consent to receive marketing and promotional messages, including special offers, discounts, and product updates, from Tampa Bay Pay at the phone number provided. Message frequency varies, message & data rates may apply. Text HELP for assistance, reply STOP to opt out.