Merchant Application

Tell us the legal and operating names of your business

Business Name / DBA*

Please enter your business name.

Legal Name*

Please enter the legal name.

Business Address*

Please enter your business address.

Legal Address*

Please enter your legal address.

Basic information about the person applying

First Name*

Please enter your first name.

Last Name*

Please enter your last name.

Email*

Please enter a valid email address.

Date of Birth*

Please select your date of birth.

Business Number*

Please enter your business number.

Mobile Number*

Please enter your mobile number.

Where your business operates and where to ship equipment

Home Address*

Please enter your home street address.

Shipping Address*

Please enter your shipping address.

Same as business address

Used to verify your business and identity

EIN / TIN*

Please enter your EIN / TIN.

SSN #*

Please enter your SSN.

PDF, JPG, or PNG — max 30MB total for all documents combined

Business License / Incorporation Documents* Click or drag & drop PDF / JPG / PNG here

No file chosen

Driver's License / Photo ID* Click or drag & drop PDF / JPG / PNG here

No file chosen

Business Voided Check* Click or drag & drop PDF / JPG / PNG here

No file chosen