ProtoPay - Seamless Digital Payments for the Future

Payment Solution You're Applying For*

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

Corporate Business Legal Name*

Corporate Address*

Corporate City*

Corporate State*

Corporate ZIP*

Corporate Phone*

Corporate Email Address*

E.I.N. / Tax ID #*

Location Name*

Location Address*

Location Phone*

Location Email

Location Contact

Location License

Website URL

Name

Address

Date of Birth

Phone

Email

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?

Owner's Drivers License or State ID

Cannabis License

Articles of Inc or Business License

Most Recent Bank Statement

Voided Check