Business Phone
Business Phone
If different from legal
http://
Please provide the following information for each individual who owns 25% or more of the equity interest of your business.
Nonprofits: Enter your Executive Director’s info in the Principal 1 section. If you don’t want to fill in the SSN/DOB section, you can alternatively email us a copy of the organization’s 501c3 documentation for underwriting.

Principal 1 *
Please provide the following information for each individual who owns 25% or more of the equity interest of your business.
Nonprofits: Enter your Executive Director’s info in the Principal 1 section. If you don’t want to fill in the SSN/DOB section, you can alternatively email us a copy of the organization’s 501c3 documentation for underwriting.

Principal 1
DOB *
DOB
Principal 2
Principal 2
DOB
DOB
Principal 3
Principal 3
DOB
DOB
Just a few more questions about your current setup...

How do you currently accept credit/debit cards? *
Check all that apply:
-If using Authorize.net, would you like to use your existing gateway or create a new one? -If using a desktop terminal, would you like to manually or auto settle batches? If auto, what time?
A rough estimate based on recent activity.
You currently accept:
Check all that apply:
Direct is directly with American Express. You'll have a separate statement, separate Merchant ID, and separate funding. You're on OptBlue if all your Amex transactions are on the same statement, same MID and same funding as Visa, MC, and Discover.