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Payment Solution You're Applying For*

Select Payment Solution*
Cashless ATM
ACH
Wallet
Hemp/CBD Credit Card Processing

Corporate Info

Corporate Business Legal Name*

Corporate Address*

Corporate City*

Corporate State*

Corporate ZIP*

Corporate Phone*

Corporate Email Address*

E.I.N. / Tax ID #*

Location Info

Location Name*

Location Address*

Location Phone*

Location Email

Location Contact

Location License

Website URL

Officer/Owner Information

Name*

Address*

Date of Birth*

Phone*

Email*

Business Operations Information

Average Sales Ticket ($)

Monthly Sales Volume ($)

Location Time Zone

# of Retail Only Terminals Needed

Wifi or Ethernet option

Wifi

Ethernet

# of Delivery Terminals Needed

If delivery, Att or Verizon?

Hemp/CBD Credit Card Pre-Application

Company Profile

Ownership Profile — Principal #1 (additional details)

Uses the Officer/Owner Information above for name, address, DOB, phone, and email. Ownership must equal 100% or more across principals.

Title

% Owned

Social Security #

Identification Type

State / County of ID

Country

Add a Principal #2 Ownership Profile

Ownership Profile — Principal #2

Name

Title

% Owned

Telephone Number

Email Address

Date of Birth

Social Security #

Identification Type

State / County of ID

Address

City, State

Zip / Postal Code

Country

Card Processing Information

Banking Information

Bank Name

Bank Address

Bank Phone Number

ABA Routing Code (US)

Account Number

Account Holder

SWIFT / BIC (optional)

IBAN Number (EU, optional)

Required Documents

Owner's Drivers License or State ID*

Cannabis License*

Most Recent Bank Statement*

Voided Check*

3 Months of Company Bank Statement (If New Business)*

3 Months of Company Bank Statements (If Existing Business)*

Voided Business Account Check with DBA or Legal Entity Name*

3 Months Processing Statements for All Accounts If Currently Processing or Processed Recently*

Drivers License for All Owners / Principal Signers*

Articles of Inc or Business License*

Application for EIN* (Download Form SS-4)

Business Application Details