The info you input below is what we will send on a formal application. Please make sure to fill in the information below accurately

BUSINESS INFORMATION

Products or Services Do You Offer:

Company Legal Name:

DBA (doing as business as):

Company Email

Company Phone Number

Company Address

City

State

Postal code

Bank Account #

Bank Routing #

Date Incorporated

Tax ID Number

Company Website URL

Is the website active?

Yes

If no, please tell why?

Customer Support #

Number of principals (Owners):

We are required to gather the details below for all owners with 25% or greater ownership.

BUSINESS BASICS

Business Structure:

LLC

Sole Proprietorships

Government

Non-Profit

Public Corp

Partnership

Corporation

Billing Model (choose all that apply)

One-time Sale

Memberships/Subscriptions

Other

PROCESSING BASICS

I plan to accept payment the following ways

In person

Online

Manually Keyed In

Invoicing a customer

Planning on multiple acceptance methods. Enter a percentage for each acceptance type.

Example: 90% in person 10% Keyed In

PROCESSING HISTORY

Has the business or any of the principals had a merchant account terminated or placed on TMF/MATCH list?

Yes

Has the business or any of the principals had ever filed for Bankruptcy?

Yes

If Yes, When and was it personal or Business ?

Current/Requested monthly processing volume:

Average sale amount ( Average Price people pay for your service/product):

Highest sale amount. ( Highest Price people pay for your service/product):

PRINCIPLE / OWNER INFORMATION:

First Name

Last Name:

Ownership %

Street Address

City

State

Zipcode

Phone

SSN

Date of birth

Driver License #

Driver License State

Driver License Expiration Date

OWNER 2 INFORMATION

If Applicable

First Name

Last Name

Ownership %

Street Address

City

State

Zipcode

Personal Phone

SSN

Date of Birth

Driver License #

Driver License State

Driver License Expiration Date

SUPPORTING DOCUMENTS

Please upload the supporting documents you have to expedite the application process

Note specific industry types will require you to upload additional documents you will be notified if additional documents are required

However, a voided check & Id will be required regardless of the industry type

multiple file-uploading options are available

Government Issued ID

UPLOAD

Voided Check or Bank Letter

UPLOAD

Bank Statements

UPLOAD

Merchant/ Processing Statements

UPLOAD

Additional uploading seciton

UPLOAD

By submitting this form, you agree to receive text messages from MacPayments LLC, These messages may include account related updates, appointment reminders, and other important account related information. You understand that standard text messaging and data rates may apply. You may opt-out of receiving these messages at any time by replying "STOP" to any text message, or by contacting us directly.

Human Check: