Form-Merchant-Processing-Account – On Time Wealth Capital

Step 1
Step 2
Step 3

Merchant Account Processing Application

First Name (Business Owner)

Last Name

Title

Business Ownership %

Personal Address

State

City

Zip Code

Year Moved In

Cell Phone Number

Social Security Number

Driver's License Number

Driver's License State

Date of Birth

Merchant Account Processing Application

Business / DBA Name

Business Legal Name

Business Typ

Date Business Established

Federal EIN

Business Phone #

Business Website

Is the Business Address same as the Business Owners Address? If not Enter Here Otherwise Leave It Blank

Is the Mailing Address same as the Business Owners Address? If not Enter Here Otherwise Leave It Blank

Briefly Describe Merchandise/Services Sold

Average Ticket Amount Anticipated Average Credit/Debit Card Sale Transaction Size

Average Monthly Volume Average Total Monthly Credit/Debit Card Sales Expected

Highest Ticket Amount* Largest Anticipated Credit/Debit Sale Transaction Size

Percent of

Accepted Electronic Payment Methods (Check All That Apply)

I use Paypal, Stripe or Square to take Credit/Debit Cards

ACH / Electronic Bank Transfers

Mobile Payments

EBT

If You have a Merchant Account to take Credit/Debit Cards

Current Merchant Account Processor

Current Merchant ID Number

Have any of the owners of the business ever had a bankcard relationship terminated?

Business Account Info

Business Bank Name

Bank Routing Number

Business Checking Acct. #

Documents Required For Prequalification

A copy of your Driver's License Choose a file

Max. size: 512.0 MB

A copy of a voided check from your business account, or you may upload a letter from your bank with your business bank account number and the bank routing number. Choose a file

Max. size: 512.0 MB

A copy of your business Articles of Organization or Articles of Incorporation, A copy of a voided check from your business account, or you may upload a letter from your bank with your business bank account number and the bank routing number. Choose a file

Max. size: 512.0 MB

A copy of your business EIN letter with your Employer Identification Number. This is the SS-4 document your received from the IRS. Choose a file

Max. size: 512.0 MB

A copy of your latest monthly processing statement from your merchant processor. Must show all transactions and fees paid (not just a Summary Report). Choose a file

Max. size: 512.0 MB