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Step 1 of 7 : Business
Business Type
*
Convenience Store
Grocery Store
Supermarket
Mini Market
Meat Market
Seafood Market
Butcher Shop
Dry Cleaner
Smoke and Tobacco Store-RETAIL
Liquor Store-Sprits, Wine, Beer
Cellular Telephone Equipment Store
Electronics Sell
Electronics Repair Shop
OTHER
Other Business Type
*
EBT
Do your accept EBT ?
*
Yes
No
EBT Card Number
*
Business Details
Legal Name of Business
*
Description of products or services
*
Year Established(YYYY)
*
Length of Ownership YEARS(0-99)
*
Length of Ownership MONTHS(1-12)
*
Ownership Type
*
Individual/ Sole Proprietor/Just DBA / Single Member LLC
Limited Liability Company S=S corporation
Limited Liability Company P=P Partners
Limited Liability Company C=C corporation
C Corporation - Private Company
Government fed/state/local
Partnership
Non Profit Org./ Tax Exempt / Charity
Estate
Trust
Club
Business Registered Id
*
Employer identification number (EIN)
Tax Identification Number (TIN)
Social Security number (SSN)
Individual Taxpayer Identification Number (ITIN)
Number
*
Country Of Primary Business Operations
*
USA
Canada, Stop! This application is for U.S.-registered businesses only.
Cell Phone Validation to Verify You’re Human
*
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