NOTE: Failure to provide accurate information may result in a withholding of merchant funding per: IRS regulations
All Owners with up to 25% or more ownership or owners with significant responsibility managing the legal entity must be added.
*Each individual who owns, directly or indirectly through any contract, arrangment, understanding relationship or otherwise, 25% or more of the equity interests of the Client, or who is the
Client’s sole proprietor, must be added.
** A Guarantor means a “beneficial owner” who is identified as the authorized signer, with significant responsibility and control (e.g. Chief Executive Officer, Chief Financial Officer, Chief
Operating Officer, Managing Member, General Partner, President, Vice President, Treasurer).
***An addendum will be provided for any owner not stated on the application with 25% or more ownership in the aforementioned company(or legal entity)
If you process 20% or more of your credit card volume without chip and or card present, please complete the section below:
1. Please submit your product catalog, brochures, promotional materials, a current price list, and a copy of your service agreement with card holder if applicable. If on the internet, please include screen-prints of your website address if your site is not yet active.