Business Type

Required

Indicates whether a business is publicly or privately held.

0 = Private

• Indicates a privately held business.

• *Sole proprietorship will automatically have a value of ‘0/Private’

1 = Public

• Indicates that the business is publicly owned.

• *Government agencies and NonProfit businesses will automatically have a value of ‘1/Public’

Legal Business Name

Required

The full legal name of the business as registered with the IRS.

DBA - Statement Descriptor

Optional

Defines how the merchant's business name will appear on the customer credit card statements. (If no descriptor is set then this will display the Legal Business Name):

• Must contain at least 1 letter.

• Special characters (& . ,) are permitted.

If a descriptor is defined, the box adjacent to this field will preview the Merchant's business name as it will appear on the cardholder’s statements.

Tax ID Business Number

Required*

A 9-digit business identification code as issues by the IRSCRA.

*If the business is a sole proprietorship and no EIN Business Number was issued enter the primary owner’s Social Security Insurance Number (SSNSIN).

Years in Business

Required

The number of years that the merchant has been in business.

Website

Required

The merchant’s public website where sales are run.

If the merchant has no website (such as a brick and mortar only business) then https://nowebsite.com should be entered in this field.

Currently Accept Credit Cards

Optional

Default is no

A toggle On/Off to specify if the merchant is currently accepts credit cards.

Annual Credit Card Sales*

Required

*Displays when “Currently Accept Credit Cards” is set to Yes

The current number of annual credit card sales for the merchant.

Business Phone

Required

The business phone number to be stored on file.

Customer Service Phone

Optional

The phone number that will show on the customer’s statement.

If no Customer Service Phoner is provided the Business Phone number on file will be displayed.

Fax

Optional

The merchants fax number (if available).

Address, Address 2, City, StateProvince, ZipPostal Code

Required

The merchants street address that is used on their tax form. PO Boxes are not allowed.

*The merchant Timezone is automatically set based on the location of the business’s address.

Email

Required

The merchant’s business email address used for electronic communication.

*Owners personal address (if different from business email) should not be used.

First Name

Required

The first name of the primary owner for the business.

Last Name

Required

The last name of the primary owner for the business

DOB (mm-dd-yyyy)

Required

The date of birth for the business primary owner.

SSNSIN

Required

The social security number for the business primary owner.

Business Title

Required

The title the merchant holds in relation to associated business. i.e - “Owner”, “CEO”, “Comptroller”, “Executive Officer”

Ownership %

Required

The percent of ownership the primary owner has for the business.

Drivers License

Optional

The driver’s license of the primary owner.

DL StateProvince

Optional

The driver’s license state of the primary owner

Significant Responsibility

Required

Is the primary owner a ‘Control Prong’ of this business? I.e. does the primary owner a controlling authority of the business, including (but not limited to) these roles: Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, Managing Member, General Partner, President, Vice Presidents, or an individual with significant legal authority to enter the Legal Entity into a commercial relationship.

Politically Exposed Person

Required

Is the primary owner a politically exposed person? Politically exposed is defined as any person/s whomthrough their prominent position or influence, is more susceptible to being involved in bribery or corruption.

Address, Address 2, City, StateProvince, ZipPostal Code

Required

The merchant's street address that is used on their tax form. PO Boxes are not allowed.

*The merchant Timezone is automatically set based on the location of the business’s address.

Email

Required*

The merchant’s email address used for electronic communication.

Owner Phone

Required*

The primary owner's phone number.