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OWNERSHIP INFORMATION
Owner 1 Name
Percent Owned
Owner 2 Name (Leave Blank If Sole Owner)
Percent Owned
Contact Name
Email Address
Best Phone Number To Reach you at
Legal Business Name
Doing Business As (DBA)
Business Street Address
City
State
Business Zip Code
Business Country
Business Phone Number
FAX Number
Date The Business Opened (Month/Day/Year)
About Your Business and Products Sold
Product, Service or Merchandise Sold
Type of Business? (Corporation, Partnership, Sole Ownership, etc.)
% Internet Orders
% Mail/Phone Order
% Face To Face (Swiped)
Estimated Average Credit Card Sale
>Estimated Credit Card Monthly Volume
Web Site Address
Have You Ever Accepted Credit Cards?
If Yes, Do You Currently Accept Credit Cards?
What Kind Of Equipment Or Online System Do You Want To Process Your Credit Card Orders (Note: Banks Now Require Transactions To Be Conducted Electronically-Paper processing Is No Longer Available)
Equipment Needs
Business Owner Personal Information
Home Address
City
State
Zip Code
Home Phone Number
Rent or Own?
What is your credit rating?
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OWNERSHIP INFORMATION