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Phone: +1 (877) 840 6753

Domestic Application

Fields marked * are required.

Business Information
Street Address of DBA
Does your website/store require integration with Shopify, WooCommerce, PrestaShop, or other platforms?
Business Type
If international, enter 9 zeros.
Officer / Owner Information
Officer's Home Address
US only.
Bank Reference
Sales & Processing
Processing History
If yes, please upload your 3 most recent monthly processing statements below.
What percent of sales will be from: MUST TOTAL 100%
What percent of sales will be for: MUST TOTAL 100%
How many days after processing the card are the product(s) / service(s) received?
Products & Policies
What countries will you primarily accept card payments from? MUST TOTAL 100%
Any recurring billing?
Documents & Additional Notes
Drag files here or
You can add files in several goes; each one is added to the list below.
    Please upload: Driver's License, Voided Check, Articles of Incorporation, Processing Statements, Business Bank Statements.
    Up to 6 files, 10 MB each, 40 MB total. Allowed: PDF, JPG, JPEG, PNG, HEIC, DOC, DOCX.

    Would you like to schedule a quick call? Text us on WhatsApp or Telegram to get started!

    WhatsApp: +1 (561) 563-4055 / +1 (754) 971-3661