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Business Information

Legal Business name *
TAX ID *
Business Email *
Date Business Started *
DBA
Business Address *
Business Phone *
Type of Ownership *

Banking Information

Bank Name *
Bank Acccount # *
Bank Routing # *
Voided Check
Maximum file size: 200 MB
Driving License
Maximum file size: 200 MB
SS4 Doc
Maximum file size: 500 MB
Statements
Maximum file size: 1,000 MB
Existing Merchant Statements and/or Completed Invoices - Proof of Payments
Additional Notes ?
Additional Notes

Owner Information

Owner Information only required for those who hold 25% ownership or more. Total must equal 100%

Owner 1

Ownership 1 % *
minimum 25% - max 100%
First Name *
Personal Email *
DOB *
Last Name *
Cell Phone # *
SSN *
Home Address *
Second Owner ?

Owner 2

Ownership 2 %
minimum 25% - max 75%
First Name
Cell phone
DOB
Last Name
Personal Email
SSN
Home Address
Third Owner?

Owner 3

Ownership 3 %
minimum 25% - max 50%
First Name
Personal Email
DOB
Last Name
Cell phone
SSN
Home Address
Fourth Owner?

Owner 4

Ownership 4 %
minimum 25% - max 25%
First Name
Personal Email
DOB
Last Name
Cell phone
SSN
Home Address